Provider Demographics
NPI:1598331639
Name:FITZGERALD, CASEY LEE (OT-R)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:LEE
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:OT-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7235 W 162ND TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66085-8238
Mailing Address - Country:US
Mailing Address - Phone:913-257-5808
Mailing Address - Fax:844-270-5788
Practice Address - Street 1:7235 W 162ND TER
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66085-8238
Practice Address - Country:US
Practice Address - Phone:913-257-5808
Practice Address - Fax:844-270-5788
Is Sole Proprietor?:No
Enumeration Date:2021-05-30
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist