Provider Demographics
NPI:1801140884
Name:TEMPLE, JAMIE LYNN (OTR/L)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LYNN
Other - Last Name:LUEDTKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:9035 N OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1548
Mailing Address - Country:US
Mailing Address - Phone:816-807-8055
Mailing Address - Fax:
Practice Address - Street 1:4713 RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-1832
Practice Address - Country:US
Practice Address - Phone:913-789-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1703082225X00000X
MO2015015763225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist