Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 003988 | MO |
NPI | 1114052453 |
---|---|
Provider Name | Mrs. Gina L Landewe |
First Address | Kansas City, MO 64180-1143 |
Second Address | Cape Girardeau, MO 63703-4928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 12/03/2021 |