Provider Demographics
NPI:1497590178
Name:SANDRIDGE, ABIGAIL SUE JUNE (OTD)
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:SUE JUNE
Last Name:SANDRIDGE
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10704 COUNTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66109-4734
Mailing Address - Country:US
Mailing Address - Phone:660-973-4519
Mailing Address - Fax:
Practice Address - Street 1:2700 SOMERSET DR
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66206-1173
Practice Address - Country:US
Practice Address - Phone:913-521-8851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist