Provider Demographics
NPI:1245395193
Name:GATSCHET, SHANA M (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:SHANA
Middle Name:M
Last Name:GATSCHET
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:PROF
Other - First Name:SHANA
Other - Middle Name:M
Other - Last Name:DREILING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2423 W MAPLE ST STE B
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-2743
Mailing Address - Country:US
Mailing Address - Phone:316-390-0772
Mailing Address - Fax:316-390-0772
Practice Address - Street 1:2423 W MAPLE ST STE B
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-2743
Practice Address - Country:US
Practice Address - Phone:316-390-0772
Practice Address - Fax:316-390-0772
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01611225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist