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NPI Code Detail

MEDICARE: KATLYN DENAE BOKHOVEN OTR/L

MEDICARE: KATLYN DENAE BOKHOVEN OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist079430IA
2225XP0200XPediatric Occupational Therapist079430IA
3225X00000XOccupational Therapist2021011699MO

General Provider Information

NPI Number : 1063885507
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATLYN DENAE BOKHOVEN OTR/L
Provider Business Mailing Address
First Line : 12605 EAST 35TH TERRACE SOUTH
Second Line :
City : INDEPENDENCE
State : MO
Zip : 64055
Country : US
Telephone Number : 641-780-9291
Fax Number :
Provider Business Practice Location Address
First Line : 10000 WORNALL RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64114-4359
Country : US
Telephone Number : 816-942-0994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2015
Last Update Date : 05/21/2021

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Directions to “ KATLYN DENAE BOKHOVEN OTR/L” Practice Location

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