Provider Demographics
NPI:1588934038
Name:GIEFER, JANET R (COTA)
Entity type:Individual
Prefix:MISS
First Name:JANET
Middle Name:R
Last Name:GIEFER
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:P.O. BOX 803
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KS
Mailing Address - Zip Code:67831
Mailing Address - Country:US
Mailing Address - Phone:316-371-1467
Mailing Address - Fax:
Practice Address - Street 1:510 W FRONTVIEW
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801
Practice Address - Country:US
Practice Address - Phone:316-371-1467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-00769224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant