Provider Demographics
NPI:1942513296
Name:FREVERT, LINDSEY JO (OT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JO
Last Name:FREVERT
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 1:801 SE WILLOW PL
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-5250
Mailing Address - Country:US
Mailing Address - Phone:816-777-8989
Mailing Address - Fax:
Practice Address - Street 1:501 W 107TH ST
Practice Address - Street 2:SUITE 430
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5919
Practice Address - Country:US
Practice Address - Phone:816-398-8448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010022782225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist