Provider Demographics
NPI:1689031593
Name:FLANAGAN, EMMYLOU AMANDA (OTD)
Entity Type:Individual
Prefix:MRS
First Name:EMMYLOU
Middle Name:AMANDA
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16913 OAKMONT DR
Mailing Address - Street 2:APT 11
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136-4117
Mailing Address - Country:US
Mailing Address - Phone:402-216-1352
Mailing Address - Fax:
Practice Address - Street 1:10000 W 75TH ST
Practice Address - Street 2:STE.250
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2209
Practice Address - Country:US
Practice Address - Phone:888-913-1910
Practice Address - Fax:877-913-1174
Is Sole Proprietor?:No
Enumeration Date:2016-01-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE901114225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist