Provider Demographics
NPI:1538532304
Name:KILGEN-HENRY, GENEVIEVE (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:MRS
First Name:GENEVIEVE
Middle Name:
Last Name:KILGEN-HENRY
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 N GRAYSTONE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67230-7247
Mailing Address - Country:US
Mailing Address - Phone:316-210-3598
Mailing Address - Fax:
Practice Address - Street 1:1526 N GRAYSTONE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67230-7247
Practice Address - Country:US
Practice Address - Phone:316-210-3598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-03
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01366225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist