Provider Demographics
NPI:1417146895
Name:GAST, TONYA F (OT)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:F
Last Name:GAST
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7720 WESTGATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66216
Mailing Address - Country:US
Mailing Address - Phone:913-206-7891
Mailing Address - Fax:
Practice Address - Street 1:7720 WESTGATE ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66216-3154
Practice Address - Country:US
Practice Address - Phone:913-206-7891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001032835225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist