Provider Demographics
NPI:1992270029
Name:EHRLICH, JEANENE (OT)
Entity type:Individual
Prefix:
First Name:JEANENE
Middle Name:
Last Name:EHRLICH
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 E IRON AVE STE 224
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3433
Mailing Address - Country:US
Mailing Address - Phone:785-407-0180
Mailing Address - Fax:
Practice Address - Street 1:626 S 3RD ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4105
Practice Address - Country:US
Practice Address - Phone:785-407-0180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01855225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist