Healthcare Provider Details

I. General information

NPI: 1699776807
Provider Name (Legal Business Name): BARBARA L GROENING OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 STATE LINE RD STE 333
LEAWOOD KS
66206-1941
US

IV. Provider business mailing address

8900 STATE LINE RD STE 333
LEAWOOD KS
66206-1941
US

V. Phone/Fax

Practice location:
  • Phone: 913-491-9404
  • Fax: 913-754-0365
Mailing address:
  • Phone: 913-491-9404
  • Fax: 913-754-0365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number000809
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17-00121
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: