Basic Information
| Provider Information | |||||||||
| NPI: | 1427097468 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAWRENCE | ||||||||
| FirstName: | JANICE | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | OTR/L, CHT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10801 E 350 HWY | ||||||||
| Address2: | |||||||||
| City: | RAYTOWN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641382367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167375500 | ||||||||
| FaxNumber: | 8167375504 | ||||||||
| Practice Location | |||||||||
| Address1: | 10801 E 350 HWY | ||||||||
| Address2: | |||||||||
| City: | RAYTOWN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641382367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167375500 | ||||||||
| FaxNumber: | 8167375504 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 12/14/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XH1200X | 002235 | MO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand | 225XH1200X | 1702222 | KS | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand | 225XH1200X | 989128 | MO | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand |
ID Information
| ID | Type | State | Issuer | Description | 35416083 | 01 | MO | BCBS | OTHER |