Provider Demographics
NPI:1083866420
Name:HOUSTON, KENAN IRWIN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KENAN
Middle Name:IRWIN
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6700 ANTIOCH RD
Mailing Address - Street 2:SUITE 430
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-1258
Mailing Address - Country:US
Mailing Address - Phone:913-652-9229
Mailing Address - Fax:913-652-9198
Practice Address - Street 1:6700 ANTIOCH RD
Practice Address - Street 2:SUITE 430
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-1258
Practice Address - Country:US
Practice Address - Phone:913-652-9229
Practice Address - Fax:913-652-9198
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004028699225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist