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General NPI Number Information
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NPI Number | 1871558346
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Entity Type | Individual
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Provider Name | MARILYN ELIZABETH BOAZ OTR CHT
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Gender | Female
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 16018 W 65TH ST
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City | SHAWNEE
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State | KS
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Zip | 66217
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Country | US
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Telephone | 913-248-1461
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Fax | 913-248-8689
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Provider Business Mailing Address
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Address Line | 21006 W 54TH ST
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City | SHAWNEE
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State | KS
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Zip | 66218
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Country | US
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Telephone | 913-422-3863
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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 | 1700556
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License Number State | KS
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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 | 2006000648
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | 9511000065
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License Number State | MO
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