Basic Information
Provider Information
NPI: 1164635744
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KROPF
FirstName: REBECCA
MiddleName: ANN
NamePrefix: MS.
NameSuffix:  
Credential: OTRL
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5107 FOLIAGE RD
Address2:  
City: SENECA
State: MO
PostalCode: 648657220
CountryCode: US
TelephoneNumber: 4176233921
FaxNumber:  
Practice Location
Address1: 2727 MC CLELLAND BLVD
Address2:  
City: JOPLIN
State: MO
PostalCode: 648041626
CountryCode: US
TelephoneNumber: 4176252197
FaxNumber: 4176252097
Other Information
ProviderEnumerationDate: 05/08/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X000406MOY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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