Provider Demographics
NPI:1992841209
Name:NEWCOMER, DEIRDRE MARIE (OTR L)
Entity Type:Individual
Prefix:MR
First Name:DEIRDRE
Middle Name:MARIE
Last Name:NEWCOMER
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10513 BARTON ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66214-3012
Mailing Address - Country:US
Mailing Address - Phone:913-599-4282
Mailing Address - Fax:
Practice Address - Street 1:3101 MAIN ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-1921
Practice Address - Country:US
Practice Address - Phone:816-841-2284
Practice Address - Fax:816-753-7836
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005061225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics