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General NPI Number Information
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NPI Number | 1235858283
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Entity Type | Individual
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Provider Name | SYDNEY CUSTER
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Gender | Female
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 29560 W LAKE MIOLA DR
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City | PAOLA
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State | KS
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Zip | 66071-1396
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Country | US
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Telephone | 913-742-3238
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Fax |
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Provider Business Mailing Address
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Address Line | 29560 W LAKE MIOLA DR
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City | PAOLA
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State | KS
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Zip | 66071-1396
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Country | US
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Telephone | 913-742-3238
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 17-04511
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2025032187
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License Number State | MO
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