Basic Information
Provider Information | |||||||||
NPI: | 1578688743 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | LAHUE | ||||||||
FirstName: | RACHEL | ||||||||
MiddleName: | L | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | OTR/L, CHT | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | WERNER | ||||||||
OtherFirstName: | RACHEL | ||||||||
OtherMiddleName: | LYNN | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 17134 BEL RAY PL | ||||||||
Address2: |   | ||||||||
City: | BELTON | ||||||||
State: | MO | ||||||||
PostalCode: | 640125331 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8162264011 | ||||||||
FaxNumber: | 8165246115 | ||||||||
Practice Location | |||||||||
Address1: | 7211 W 110TH ST | ||||||||
Address2: |   | ||||||||
City: | OVERLAND PARK | ||||||||
State: | KS | ||||||||
PostalCode: | 662102339 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9134517372 | ||||||||
FaxNumber: | 9134517375 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/20/2007 | ||||||||
LastUpdateDate: | 01/27/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XH1200X | 1701152 | KS | Y |   | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand |
ID Information
ID | Type | State | Issuer | Description | 29357041 | 01 |   | BCBS KC | OTHER | KA2868012 | 01 | KS | MEDICARE PTAN | OTHER |