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General NPI Number Information
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NPI Number | 1245430560
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Entity Type | Individual
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Provider Name | KERRY L MCINTOSH OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 7105 MISSION RD
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-3077
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Country | US
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Telephone | 913-831-0164
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 PENNSYLVANIA AVE APT 302
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City | KANSAS CITY
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State | MO
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Zip | 64105-1303
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Country | US
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Telephone | 816-214-6483
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 17-00770
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License Number State | KS
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