Healthcare Provider Details

I. General information

NPI: 1356816292
Provider Name (Legal Business Name): KARA HOEGERL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2018
Last Update Date: 10/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 BALTIMORE AVE
KANSAS CITY MO
64108-3403
US

IV. Provider business mailing address

11014 W 124TH TER
OVERLAND PARK KS
66213-2150
US

V. Phone/Fax

Practice location:
  • Phone: 816-751-7700
  • Fax:
Mailing address:
  • Phone: 785-840-6353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number2018035271
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: