Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | 002092 | MO |
Y | 225XH1200X | Occupational Therapist - Hand | 17-000153 | KS |
NPI | 1255370532 |
---|---|
Provider Name | Laurie A Reed |
First Address | Belton, MO 64012-5331 |
Second Address | Overland Park, KS 66210-2339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 11/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
22397092 | BCBS KC (01) | |
KA2868006 | MEDICARE PTAN (01) | KS |
MA4370069 | MEDICARE PTAN (01) | MO |