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General NPI Number Information
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NPI Number | 1407070444
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Entity Type | Individual
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Provider Name | MRS. KATHERINE DEANNE SHIFRIN
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 622 N EDGEMOOR ST
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City | WICHITA
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State | KS
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Zip | 67208-3602
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Country | US
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Telephone | 316-686-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 800 S ABILENE AVE
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City | VALLEY CENTER
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State | KS
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Zip | 67147-2155
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Country | US
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Telephone | 316-260-1287
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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 | 17-02326
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License Number State | KS
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