MEDICARE: MARIA LINDBERGH MOT, ECHM, 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
1	225XE0001X	Environmental Modification Occupational Therapist	2014022520	MO

General Provider Information

NPI Number	:	1790173755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA LINDBERGH MOT, ECHM, OTR/L

Provider Business Mailing Address
First Line	:	14120 N ROBINHOOD LN
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64164-1219
Country	:	US
Telephone Number	:	816-721-3034
Fax Number	:

Provider Business Practice Location Address
First Line	:	14120 N ROBINHOOD LN
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64164
Country	:	US
Telephone Number	:	816-721-3034
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2014
Last Update Date	:	08/20/2018

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