Healthcare Provider Details

I. General information

NPI: 1689504052
Provider Name (Legal Business Name): DAKOTA BURNETT OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 N WASHINGTON AVE
WALNUT GROVE MO
65770-8126
US

IV. Provider business mailing address

611 N WASHINGTON AVE
WALNUT GROVE MO
65770-8126
US

V. Phone/Fax

Practice location:
  • Phone: 417-633-5104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: