Provider Demographics
NPI:1487833273
Name:TAYLOR, AMY E (OTR)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:TAYLOR
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 1:6036 ROSEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66205-3055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8900 STATE LINE RD
Practice Address - Street 2:STE 333
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66206-1941
Practice Address - Country:US
Practice Address - Phone:913-626-2868
Practice Address - Fax:913-754-0365
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1702107225X00000X
MO2004015596225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2004015596OtherSTATE LICENSE
KS1702107OtherSTATE LICENSE