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Individual

JOYCE MARIE KALLENBERGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8200 NW WEATHERBY DR, WEATHERBY LAKE, MO 64152-1596
(816) 694-5494
Mailing address
8200 NW WEATHERBY DR, WEATHERBY LAKE, MO 64152-1596
(816) 694-5494

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2004011316
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2004011316
DIVISION OF PROFESSIONAL REGISTRATION
MO
Enumeration date
06/03/2019
Last updated
06/03/2019
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