Provider Demographics
NPI:1649079724
Name:COY, BIANCA (OTD)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:COY
Suffix:
Gender:
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29607 NE 166TH ST
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64024-8438
Mailing Address - Country:US
Mailing Address - Phone:816-806-3198
Mailing Address - Fax:
Practice Address - Street 1:705 W 31ST ST
Practice Address - Street 2:
Practice Address - City:HIGGINSVILLE
Practice Address - State:MO
Practice Address - Zip Code:64037-1828
Practice Address - Country:US
Practice Address - Phone:660-584-7127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025007441225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist