Provider Demographics
NPI:1518157015
Name:LARSON, KRISTEN R (OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:R
Last Name:LARSON
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:A
Other - Last Name:HEDENSKOG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17134 BEL RAY PL
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-5331
Mailing Address - Country:US
Mailing Address - Phone:816-226-4011
Mailing Address - Fax:816-524-6115
Practice Address - Street 1:7932 N OAK TRFY
Practice Address - Street 2:SUITE 212
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-1423
Practice Address - Country:US
Practice Address - Phone:816-420-0286
Practice Address - Fax:816-420-8207
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004600225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
39315041OtherBCBS KC
MOMA4370038OtherMEDICARE PTAN