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General NPI Number Information
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NPI Number | 1639854474
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Entity Type | Individual
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Provider Name | MOLLIE ELIZABETH CALDERON
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Gender | Female
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 8550 MARSHALL DR STE 210
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City | LENEXA
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State | KS
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Zip | 66214-9836
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Country | US
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Telephone | 913-492-0333
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Fax | 913-492-0334
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Provider Business Mailing Address
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Address Line | 200 W DOUGLAS AVE STE 250
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City | WICHITA
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State | KS
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Zip | 67202-3002
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Country | US
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Telephone | 316-263-0003
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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 | T-05957
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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 | 17-04173
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License Number State | KS
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