Individual
DEBORAH L BUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
10801 E STATE ROUTE 350, RAYTOWN, MO 64138-2367
(816) 737-5502
(816) 737-5504
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(816) 226-4011
(816) 524-6115
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
17-01557
KS
225X00000X
Occupational Therapist
Primary
2006011923
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46002038
BCBS-KC
—
05
—
477599906
—
MO
01
—
KA2868053
MEDICARE PTAN
KS
01
—
MA4370075
MEDICARE PTAN
MO
Enumeration date
02/22/2007
Last updated
06/11/2014
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