MEDICARE: AMY L PAULSON OT, CHT

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	225X00000X	Occupational Therapist	2000160749	MO

General Provider Information

NPI Number	:	1912918806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY L PAULSON OT, CHT

Provider Business Mailing Address
First Line	:	11005 N CENTRAL ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-3611
Country	:	US
Telephone Number	:	816-572-3994
Fax Number	:

Provider Business Practice Location Address
First Line	:	8002 N OAK TRFY
Second Line	:	STE 112
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-1268
Country	:	US
Telephone Number	:	816-572-3994
Fax Number	:

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	12/27/2016

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