Provider Demographics
NPI:1912348673
Name:POWERS, MAGGIE NICOLE (MOT)
Entity Type:Individual
Prefix:MISS
First Name:MAGGIE
Middle Name:NICOLE
Last Name:POWERS
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 SW RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-1536
Mailing Address - Country:US
Mailing Address - Phone:785-506-8745
Mailing Address - Fax:785-232-2097
Practice Address - Street 1:2701 SW RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-1536
Practice Address - Country:US
Practice Address - Phone:785-506-8745
Practice Address - Fax:785-232-2097
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-03671225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist