Provider Demographics
NPI:1649676800
Name:TURNEY, KORI MICHELLE (OTR/L)
Entity type:Individual
Prefix:
First Name:KORI
Middle Name:MICHELLE
Last Name:TURNEY
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 1:1055 N. 199TH ST W
Mailing Address - Street 2:
Mailing Address - City:GODDARD
Mailing Address - State:KS
Mailing Address - Zip Code:67052
Mailing Address - Country:US
Mailing Address - Phone:316-204-1259
Mailing Address - Fax:
Practice Address - Street 1:1055 N. 199TH ST W
Practice Address - Street 2:
Practice Address - City:GODDARD
Practice Address - State:KS
Practice Address - Zip Code:67052
Practice Address - Country:US
Practice Address - Phone:316-204-1259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-14
Last Update Date:2018-11-07
Deactivation Date:2018-04-06
Deactivation Code:
Reactivation Date:2018-11-07
Provider Licenses
StateLicense IDTaxonomies
KS17-01653225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist