Provider Demographics
NPI:1720336944
Name:TOSATTO, EMMA MALIWAT (OT)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:MALIWAT
Last Name:TOSATTO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3324 S ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-1223
Mailing Address - Country:US
Mailing Address - Phone:816-795-7903
Mailing Address - Fax:
Practice Address - Street 1:14820 E 42ND ST S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-4775
Practice Address - Country:US
Practice Address - Phone:816-695-1255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012024483225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist