Provider Demographics
NPI:1811946015
Name:ATCHISON, KATHLEEN A (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:ATCHISON
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17134 BEL RAY PL
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-5331
Mailing Address - Country:US
Mailing Address - Phone:816-226-4011
Mailing Address - Fax:816-524-6115
Practice Address - Street 1:3355 MAIN ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-1904
Practice Address - Country:US
Practice Address - Phone:816-399-4640
Practice Address - Fax:816-399-0801
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005013023225XH1200X
KS17-02441225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
35671062OtherBCBS KC
MOMA4370058OtherMEDICARE PTAN
KSKA2868005OtherMEDICARE PTAN