Provider Demographics
NPI:1891013025
Name:MOGENSON, KERI (OT)
Entity Type:Individual
Prefix:MISS
First Name:KERI
Middle Name:
Last Name:MOGENSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8005 AUDRAIN DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-4629
Mailing Address - Country:US
Mailing Address - Phone:816-799-1767
Mailing Address - Fax:
Practice Address - Street 1:4400 W 115TH ST
Practice Address - Street 2:217
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-2684
Practice Address - Country:US
Practice Address - Phone:913-663-2912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist