Provider Demographics
NPI:1245325208
Name:KNIGHT, KELLI JO (OT)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:JO
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:JO
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:4900 S ARROWHEAD DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-6952
Mailing Address - Country:US
Mailing Address - Phone:816-795-6999
Mailing Address - Fax:816-795-3366
Practice Address - Street 1:4900 S ARROWHEAD DR
Practice Address - Street 2:SUITE B
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-6952
Practice Address - Country:US
Practice Address - Phone:816-795-6999
Practice Address - Fax:816-795-3366
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007017185225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist