Provider Demographics
NPI:1003514811
Name:WALSH, PAULA DIANNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:DIANNE
Last Name:WALSH
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 ARMOUR RD STE 200
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3527
Mailing Address - Country:US
Mailing Address - Phone:816-895-9126
Mailing Address - Fax:816-895-5436
Practice Address - Street 1:6701 W 121ST ST STE 300
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209-2034
Practice Address - Country:US
Practice Address - Phone:913-498-8492
Practice Address - Fax:913-498-8498
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-07269225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist