Healthcare Provider Details

I. General information

NPI: 1679175087
Provider Name (Legal Business Name): MOLLY CHRISTINE YUELKENBECK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 W 133RD ST
LEAWOOD KS
66209-3347
US

IV. Provider business mailing address

11321 CRAIG ST
OVERLAND PARK KS
66210-1830
US

V. Phone/Fax

Practice location:
  • Phone: 913-213-3531
  • Fax:
Mailing address:
  • Phone: 913-620-4359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number17-03781
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: