Provider Demographics
NPI:1467045161
Name:STETINA, BRIANNA (OTA)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:STETINA
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 NAVAJO ST
Mailing Address - Street 2:
Mailing Address - City:NEW STRAWN
Mailing Address - State:KS
Mailing Address - Zip Code:66839-9137
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7220 SW ASBURY DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-4706
Practice Address - Country:US
Practice Address - Phone:785-478-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-05446224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant