Provider Demographics
NPI:1033438155
Name:SHOGREN, VELVET (OTR)
Entity Type:Individual
Prefix:
First Name:VELVET
Middle Name:
Last Name:SHOGREN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PARKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:HESSTON
Mailing Address - State:KS
Mailing Address - Zip Code:67062-9048
Mailing Address - Country:US
Mailing Address - Phone:620-327-3300
Mailing Address - Fax:
Practice Address - Street 1:200 W CEDAR ST
Practice Address - Street 2:
Practice Address - City:HESSTON
Practice Address - State:KS
Practice Address - Zip Code:67062-8100
Practice Address - Country:US
Practice Address - Phone:620-327-2544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-00191225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist