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General NPI Number Information
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NPI Number | 1356817720
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Entity Type | Individual
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Provider Name | JODI STAATS MOTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/23/2018
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 201 MAIN ST STE 9
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City | PARKVILLE
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State | MO
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Zip | 64152-3645
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Country | US
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Telephone | 816-651-1868
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Fax |
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Provider Business Mailing Address
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Address Line | 100 W CALICO DR
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City | RAYMORE
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State | MO
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Zip | 64083-8500
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Country | US
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Telephone |
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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 | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2018030856
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License Number State | MO
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