Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | 1051100158 | KS |
Y | 225XH1200X | Occupational Therapist - Hand | 17-01925 | KS |
N | 225XH1200X | Occupational Therapist - Hand | 2014008481 | MO |
NPI | 1215976584 |
---|---|
Provider Name | Lora L Wendling |
First Address | Belton, MO 64012-5331 |
Second Address | Shawnee, KS 66216-3800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 25/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
33826065 | BCBS KC (01) | |
KA2868010 | MEDICARE PTAN (01) | KS |