MEDICARE: KATELYN JANE ZIMORINO OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1285254946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN JANE ZIMORINO OTR/L

Provider Business Mailing Address
First Line	:	1101 WALNUT ST UNIT 1309
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64106-4207
Country	:	US
Telephone Number	:	602-339-9379
Fax Number	:

Provider Business Practice Location Address
First Line	:	2220 N 59TH ST STE 114
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66104-2821
Country	:	US
Telephone Number	:	913-302-0861
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2020
Last Update Date	:	04/23/2020

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