Provider Demographics
NPI:1659095453
Name:DOWNEY, MCKENZIE RAEANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:RAEANNE
Last Name:DOWNEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MCKENZIE
Other - Middle Name:
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6208 W 120TH ST APT 26
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3730
Mailing Address - Country:US
Mailing Address - Phone:816-592-9331
Mailing Address - Fax:
Practice Address - Street 1:700 W 121ST ST SUITE 110
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209
Practice Address - Country:US
Practice Address - Phone:913-912-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1704074225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist