Provider Demographics
NPI:1942835004
Name:TRUAX, TAMMY RENEE (OTR)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:RENEE
Last Name:TRUAX
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 W 75TH ST STE 121
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2241
Mailing Address - Country:US
Mailing Address - Phone:913-362-7518
Mailing Address - Fax:981-336-2730
Practice Address - Street 1:5301 HARRY S TRUMAN DR
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-1708
Practice Address - Country:US
Practice Address - Phone:913-362-7518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004003721225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist