Provider Demographics
NPI:1063663003
Name:MYERS, JAMIE LOUISE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LOUISE
Last Name:MYERS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:JAMIE
Other - Middle Name:LOUISE
Other - Last Name:FRACOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7535 FALMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-4007
Mailing Address - Country:US
Mailing Address - Phone:913-271-0721
Mailing Address - Fax:913-642-2708
Practice Address - Street 1:7535 FALMOUTH ST
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-4007
Practice Address - Country:US
Practice Address - Phone:913-271-0721
Practice Address - Fax:913-642-2708
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008019676225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist