Provider Demographics
NPI:1598524969
Name:ANDERSON, AARON EDWARD (OTR/L, CAPS, ECHM)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:EDWARD
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:OTR/L, CAPS, ECHM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12896 W 93RD ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-3704
Mailing Address - Country:US
Mailing Address - Phone:913-907-4231
Mailing Address - Fax:
Practice Address - Street 1:12896 W 93RD ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3704
Practice Address - Country:US
Practice Address - Phone:913-907-4231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-03811225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist