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General NPI Number Information
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NPI Number | 1396123956
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Entity Type | Individual
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Provider Name | ANDREA MEGAN SOUTHARD OTR/L
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Gender | Female
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Dates
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Enumeration Date | 05/14/2015
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 5420 W 151ST ST
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City | LEAWOOD
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State | KS
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Zip | 66224-8713
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Country | US
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Telephone | 913-219-5696
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Fax |
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Provider Business Mailing Address
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Address Line | 13141 S SUMMIT ST
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City | OLATHE
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State | KS
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Zip | 66062-8804
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Country | US
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Telephone | 913-660-6883
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 2014035222
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 17-03037
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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