Healthcare Provider Details

I. General information

NPI: 1154526309
Provider Name (Legal Business Name): LINDA HICKEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10601 E 35TH TER S
INDEPENDENCE MO
64052-1113
US

IV. Provider business mailing address

10601 E 35TH TER S
INDEPENDENCE MO
64052-1113
US

V. Phone/Fax

Practice location:
  • Phone: 816-358-1955
  • Fax:
Mailing address:
  • Phone: 816-358-1955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number001681
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: LINDA KAY HICKEY
Title or Position: PROPRIETOR
Credential: OTR
Phone: 816-358-1955