Provider Demographics
NPI:1790173755
Name:LINDBERGH, MARIA (MOT, ECHM, OTR/L)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LINDBERGH
Suffix:
Gender:F
Credentials:MOT, ECHM, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14120 N ROBINHOOD LN
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64164-1219
Mailing Address - Country:US
Mailing Address - Phone:816-721-3034
Mailing Address - Fax:
Practice Address - Street 1:14120 N ROBINHOOD LN
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64164
Practice Address - Country:US
Practice Address - Phone:816-721-3034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-29
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014022520225XE0001X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Yes225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification