Individual
MALISSA SHULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
801 NW SAINT MARY DR, SUITE 220, BLUE SPRINGS, MO 64014-2524
(816) 220-3900
(816) 220-0877
Mailing address
304 SE SUNNYSIDE SCHOOL CIR, BLUE SPRINGS, MO 64014-3679
(816) 220-3900
(816) 220-0877
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2006012395
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37008018
BCBS PROVIDER NUMBER
MO
Enumeration date
03/09/2007
Last updated
07/09/2007
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