Provider Demographics
NPI:1891864534
Name:O'BYRNE, LORA BETH (OT)
Entity Type:Individual
Prefix:MS
First Name:LORA
Middle Name:BETH
Last Name:O'BYRNE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:BETH
Other - Last Name:SHIPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:15917 ANTIOCH RD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2924
Mailing Address - Country:US
Mailing Address - Phone:913-239-9539
Mailing Address - Fax:913-239-9893
Practice Address - Street 1:15917 ANTIOCH RD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2924
Practice Address - Country:US
Practice Address - Phone:913-239-9539
Practice Address - Fax:913-239-9893
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01842225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17-01842OtherOT LICENSE
MO1999141041OtherLICENSE#