Provider Demographics
NPI:1679175087
Name:VAETH, MOLLY CHRISTINE (OTR/L)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:CHRISTINE
Last Name:VAETH
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 1:11321 CRAIG ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1830
Mailing Address - Country:US
Mailing Address - Phone:913-620-4359
Mailing Address - Fax:
Practice Address - Street 1:18905 W 175TH ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-8933
Practice Address - Country:US
Practice Address - Phone:913-620-4359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-03781225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics