Provider Demographics
NPI:1366746885
Name:WICHMANN, LYNNE MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:MARIE
Last Name:WICHMANN
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 1:9808 KNOX DR
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5226
Mailing Address - Country:US
Mailing Address - Phone:913-707-4308
Mailing Address - Fax:913-789-9900
Practice Address - Street 1:7819 CONSER PL
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-2820
Practice Address - Country:US
Practice Address - Phone:913-707-4308
Practice Address - Fax:913-789-9900
Is Sole Proprietor?:No
Enumeration Date:2010-12-23
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1702174225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist