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NPI Code Detail

MEDICARE: MRS. ANGELA RENEE WONG OT, LIMITED PERMIT

MEDICARE: MRS. ANGELA RENEE WONG OT, LIMITED PERMIT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistT-00666KS

General Provider Information

NPI Number : 1932312881
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA RENEE WONG OT, LIMITED PERMIT
Provider Business Mailing Address
First Line : 7239 EBY AVE
Second Line : APT. 205
City : OVERLAND PARK
State : KS
Zip : 66204-1638
Country : US
Telephone Number : 816-589-5343
Fax Number :
Provider Business Practice Location Address
First Line : 6700 ANTIOCH RD
Second Line : STE 430
City : OVERLAND PARK
State : KS
Zip : 66204-1258
Country : US
Telephone Number : 888-652-9225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2007
Last Update Date : 07/08/2007

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