Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251E1200X | Ergonomics | 2009035057 | MO |
Y | 225XE1200X | Ergonomics | 2009035057 | MO |
N | 225XE0001X | Environmental Modification | 2009035057 | MO |
N | 225XG0600X | Occupational Therapist - Gerontology | 2009035057 | MO |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 20090305057 | MO |
NPI | 1578892766 |
---|---|
Provider Name | Mrs. Gwendolyn R Pearl |
First Address | Kansas City, KS 66109-3463 |
Second Address | Kansas City, KS 66109-3463 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2009 |
Last Update Date | 17/12/2009 |