Provider Demographics
NPI:1740424878
Name:BRABENDER, TRISHA L (RPT)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:L
Last Name:BRABENDER
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:L
Other - Last Name:MANGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:DEPT CH14389
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60055-4389
Mailing Address - Country:US
Mailing Address - Phone:785-295-5307
Mailing Address - Fax:785-270-7646
Practice Address - Street 1:3310 SE 29TH STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66605
Practice Address - Country:US
Practice Address - Phone:785-270-7444
Practice Address - Fax:785-273-1676
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1101981225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist