Organization
ST. NICHOLAS CHILDREN'S THERAPIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH J HERZOG OTR/L (OWBER)
(913) 579-8556
Entity
Organization
Contact information
Practice address
3811 W 52ND ST, ROELAND PARK, KS 66205-1458
(913) 579-8556
(816) 763-1802
Mailing address
3811 W 52ND ST, ROELAND PARK, KS 66205-1458
(913) 579-8556
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34966016
BCBS OF KANSAS CITY GROUP
MO
Enumeration date
08/18/2005
Last updated
12/30/2022
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