Healthcare Provider Details

I. General information

NPI: 1225977408
Provider Name (Legal Business Name): LINDSEY M. FUENTES OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25703 33RD STREET CT
BLUE SPRINGS MO
64015-1111
US

IV. Provider business mailing address

25703 33RD STREET CT
BLUE SPRINGS MO
64015-1111
US

V. Phone/Fax

Practice location:
  • Phone: 417-300-4058
  • Fax:
Mailing address:
  • Phone: 417-300-4058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2026007337
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: