Healthcare Provider Details

I. General information

NPI: 1588329932
Provider Name (Legal Business Name): JAIDEN BRIE GATCHALIAN MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 S SWOPE DR
INDEPENDENCE MO
64057-2808
US

IV. Provider business mailing address

10433 WYANDOTTE ST
KANSAS CITY MO
64114-4734
US

V. Phone/Fax

Practice location:
  • Phone: 816-257-5100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2026013046
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: