MEDICARE: HANNA CHURCHILL

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
1	106S00000X	Behavior Technician
2	225X00000X	Occupational Therapist	17-04391	KS

General Provider Information

NPI Number	:	1962032219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNA CHURCHILL

Provider Business Mailing Address
First Line	:	7724 REEDS RD
Second Line	:
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66208-4759
Country	:	US
Telephone Number	:	314-609-8211
Fax Number	:

Provider Business Practice Location Address
First Line	:	15044 S BLACKBOB RD
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-2663
Country	:	US
Telephone Number	:	913-449-9696
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2020
Last Update Date	:	10/31/2024

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Directions to “ HANNA CHURCHILL ” Practice Location

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