Healthcare Provider Details

I. General information

NPI: 1396519385
Provider Name (Legal Business Name): ANNA WALLISCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OLATHE BLVD
KANSAS CITY KS
66160
US

IV. Provider business mailing address

2106 OLATHE BLVD MS 4004
KANSAS CITY KS
66160
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6300
  • Fax: 913-588-2253
Mailing address:
  • Phone: 913-588-6300
  • Fax: 913-588-2253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17-03103
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: