Provider Demographics
NPI:1720263361
Name:MCDOWELL, MARY ANNE
Entity Type:Individual
Prefix:
First Name:MARY ANNE
Middle Name:
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 W CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2830
Mailing Address - Country:US
Mailing Address - Phone:816-523-3736
Mailing Address - Fax:816-523-7089
Practice Address - Street 1:42 W CONCORD AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-2830
Practice Address - Country:US
Practice Address - Phone:816-523-3736
Practice Address - Fax:816-523-7089
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-00208225XH1200X
MO2002030199225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand