Healthcare Provider Details

I. General information

NPI: 1124046156
Provider Name (Legal Business Name): TONI MARIA PUTNAM OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 EAST LINWOOD BOULEVARD
KANSAS MO
62128-2295
US

IV. Provider business mailing address

1508 N EMERY
INDEPENDENCE MO
64050
US

V. Phone/Fax

Practice location:
  • Phone: 816-861-4700
  • Fax: 816-922-4647
Mailing address:
  • Phone: 816-836-2899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17-00268
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: