Provider Demographics
NPI:1992007629
Name:MAHAN, SHERI D (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:D
Last Name:MAHAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BX 1289 M
Mailing Address - Street 2:MERCY REGIONAL HEALTH CENTER
Mailing Address - City:MANHATTON
Mailing Address - State:KS
Mailing Address - Zip Code:66505
Mailing Address - Country:US
Mailing Address - Phone:785-776-3322
Mailing Address - Fax:785-539-9473
Practice Address - Street 1:455 E POYNTZ
Practice Address - Street 2:MERCY REGIONAL HEALTH CENTER
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502
Practice Address - Country:US
Practice Address - Phone:785-587-4220
Practice Address - Fax:785-539-9473
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-00667225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist