Basic Information
| Provider Information | |||||||||
| NPI: | 1548472608 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FORNELLI | ||||||||
| FirstName: | JONI | ||||||||
| MiddleName: | UNRUH | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2547 ARKANSAS ST | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660464533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858433492 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1501 INVERNESS DR | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660471870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858388000 | ||||||||
| FaxNumber: | 7858388972 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2007 | ||||||||
| LastUpdateDate: | 02/14/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 17-00474 | KS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.