Provider Demographics
NPI:1578196630
Name:WINTERSCHEIDT, MICHAELA LAUREN (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:MICHAELA
Middle Name:LAUREN
Last Name:WINTERSCHEIDT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MS
Other - First Name:MICHAELA
Other - Middle Name:LAUREN
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:819 OREGON ST
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434
Mailing Address - Country:US
Mailing Address - Phone:785-742-2201
Mailing Address - Fax:785-933-2085
Practice Address - Street 1:819 OREGON ST
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434
Practice Address - Country:US
Practice Address - Phone:785-742-2201
Practice Address - Fax:785-742-2202
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-01672225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist