Provider Demographics
NPI:1689029092
Name:ANDERSON, EMILY P (OT/R)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:P
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:OT/R
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:P
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8700 E 29TH ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2169
Mailing Address - Country:US
Mailing Address - Phone:316-634-8792
Mailing Address - Fax:316-634-8889
Practice Address - Street 1:8700 E 29TH ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2169
Practice Address - Country:US
Practice Address - Phone:316-634-8792
Practice Address - Fax:316-634-8889
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201148520AMedicaid