Provider Demographics
NPI:1467863910
Name:PARTRIDGE, MICHELLE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:PARTRIDGE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:DAWN
Other - Last Name:BUDREAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:BUILDING 2200, 3500 N. ROCK RD. #101
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226
Mailing Address - Country:US
Mailing Address - Phone:316-440-3316
Mailing Address - Fax:
Practice Address - Street 1:221 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-3037
Practice Address - Country:US
Practice Address - Phone:620-326-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-17
Last Update Date:2019-04-18
Deactivation Date:2018-12-14
Deactivation Code:
Reactivation Date:2019-03-26
Provider Licenses
StateLicense IDTaxonomies
KS18-00962224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant