Provider Demographics
NPI:1124046156
Name:PUTNAM, TONI MARIA (OTR)
Entity Type:Individual
Prefix:MS
First Name:TONI
Middle Name:MARIA
Last Name:PUTNAM
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 N EMERY
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64050
Mailing Address - Country:US
Mailing Address - Phone:816-836-2899
Mailing Address - Fax:
Practice Address - Street 1:4801 EAST LINWOOD BOULEVARD
Practice Address - Street 2:
Practice Address - City:KANSAS
Practice Address - State:MO
Practice Address - Zip Code:62128-2295
Practice Address - Country:US
Practice Address - Phone:816-861-4700
Practice Address - Fax:816-922-4647
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-00268225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist