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General NPI Number Information
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NPI Number | 1578765343
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Entity Type | Individual
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Provider Name | ANAGHA ASHOK DEOLE OTR L
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Gender | Female
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1102 E CENTENNIAL DR
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City | PITTSBURG
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State | KS
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Zip | 66762-6643
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Country | US
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Telephone | 620-232-0229
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Fax | 620-235-7817
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Provider Business Mailing Address
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Address Line | 1008 OHIO ST
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City | PITTSBURG
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State | KS
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Zip | 66762-6437
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Country | US
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Telephone | 620-231-3316
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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 | 17-00823
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License Number State | KS
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