Healthcare Provider Details

I. General information

NPI: 1992360465
Provider Name (Legal Business Name): RAQUEL O'CONNOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15520 COLLEGE BLVD
LENEXA KS
66219-1353
US

IV. Provider business mailing address

15520 COLLEGE BLVD
LENEXA KS
66219-1353
US

V. Phone/Fax

Practice location:
  • Phone: 913-386-5500
  • Fax:
Mailing address:
  • Phone: 913-386-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: