Organization
KENNY ROGERS CHILDREN'S CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE R FAYETTE (EXECUTIVE DIRECTOR)
(573) 472-0397
Entity
Organization
Contact information
Practice address
300 FLOYD DR, SIKESTON, MO 63801-3960
(573) 472-0397
(573) 472-0409
Mailing address
300 FLOYD DRIVE, P.O. BOX 608, SIKESTON, MO 63801-0608
(573) 472-0397
(573) 472-0409
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/30/2006
Last updated
09/11/2025
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