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General NPI Number Information
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NPI Number | 1578331278
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Entity Type | Organization
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Legal Business Name | AMY G. DALA THERAPY
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Dates
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Enumeration Date | 12/13/2023
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 9513 E CHAMPIONS ST
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City | WICHITA
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State | KS
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Zip | 67226-3350
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Country | US
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Telephone | 316-258-4102
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Fax |
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Provider Business Mailing Address
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Address Line | 9513 E CHAMPIONS ST
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City | WICHITA
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State | KS
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Zip | 67226-3350
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Country | US
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Telephone | 316-258-4102
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | PATRICE PETE
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Credential |
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Telephone | 316-258-4102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2081P0301X
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Taxonomy Name | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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