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Individual

MAKENZIE SAKUMURA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
OT19401
FL
225X00000X
Occupational Therapist
Primary
OT19401
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100932200
FL
05
102832100
FL
01
Y911W
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/20/2018
Last updated
05/04/2021
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