Individual
MRS. JULIA L MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA,L
Contact information
Practice address
10300 W 103RD ST, SUITE 300, OVERLAND PARK, KS 66214-2642
(913) 894-1910
Mailing address
4435 W 152ND CT, LEAWOOD, KS 66224-9782
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18-00225
KS
174400000X
Specialist
2002030254
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18-00225
STATE LICENSE NUMBER
KS
01
—
2002030254
STATE LICENSE NUMBER
MO
Enumeration date
03/07/2007
Last updated
07/08/2007
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