Provider Demographics
NPI:1023794559
Name:CUMMINGS, ELEANOR JANE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:JANE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:ELEANOR
Other - Middle Name:JANE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6219 CERNECH RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66104-1153
Mailing Address - Country:US
Mailing Address - Phone:913-475-1419
Mailing Address - Fax:
Practice Address - Street 1:1605 DAVIS RD
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-3233
Practice Address - Country:US
Practice Address - Phone:785-330-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-04175225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist