Individual
DR. JAIRRAH LA NEACE GODSIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, OTD, MOT
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3380
(816) 302-9979
Mailing address
ATTN: PROVIDER ENROLLMENT DEPARTMENT, 2401 GILLHAM ROAD, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
17-03386
KS
225X00000X
Occupational Therapist
Primary
2018004819
MO
225X00000X
Occupational Therapist
OT17857
CA
Other
Enumeration date
11/26/2018
Last updated
01/18/2024
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