Kyle Young
Individual provider Active NPI Occupational Therapist · Jefferson Cty, MO
NPI 1043477490 · NPPES record last updated May 21, 2008
Key facts
- NPI
- 1043477490
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 103196 (MN)
- Practice address
- 1416 Fairgrounds Rd
Jefferson Cty, MO 65109-0474 - Phone
- (573) 280-6494
- NPI assigned
- May 21, 2008
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103196 | MN | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 103196 | MN | Yes |
Addresses
Primary practice location
1416 Fairgrounds Rd
Jefferson Cty, MO 65109-0474
Mailing address
1416 Fairgrounds Rd
Jefferson Cty, MO 65109-0474
Other providers in Jefferson Cty, MO
- Luxottica Retail North America Inc
- Pollock Psychological Services LLC
- Rehab Solutions,LLC
- Bart V Rhoads
- Jaywanna Rodgers
All providers in Jefferson Cty, MO · Occupational Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.