Individual
MRS. JAQUELINE KOKE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
7803 NE 72ND TER, KANSAS CITY, MO 64158-1268
(816) 756-0780
(816) 756-1677
Mailing address
7803 NE 72ND TER, KANSAS CITY, MO 64158-1268
(816) 415-9399
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
003592
MO
225XP0200X
Pediatric Occupational Therapist
Primary
003592
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
478149826
—
MO
Enumeration date
02/14/2006
Last updated
08/21/2009
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