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NPI Code Detail

MEDICARE: DESIRAE GRAYBILL OTR/L

MEDICARE: DESIRAE GRAYBILL 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 TherapistT-06087KS

General Provider Information

NPI Number : 1073377263
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESIRAE GRAYBILL OTR/L
Provider Business Mailing Address
First Line : 12351 W 96TH TER STE 203
Second Line :
City : LENEXA
State : KS
Zip : 66215-4410
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3039 TROOST AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64109-1540
Country : US
Telephone Number : 816-756-3511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2024
Last Update Date : 02/17/2026

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