Provider Demographics
NPI:1316256522
Name:PFAFF, DEEA KAY (COTA)
Entity type:Individual
Prefix:
First Name:DEEA
Middle Name:KAY
Last Name:PFAFF
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25491 AA RD
Mailing Address - Street 2:
Mailing Address - City:BROWNELL
Mailing Address - State:KS
Mailing Address - Zip Code:67521-2545
Mailing Address - Country:US
Mailing Address - Phone:785-731-6244
Mailing Address - Fax:
Practice Address - Street 1:25491 AA RD
Practice Address - Street 2:
Practice Address - City:BROWNELL
Practice Address - State:KS
Practice Address - Zip Code:67521-2545
Practice Address - Country:US
Practice Address - Phone:785-731-6244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-00539224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant