Provider Demographics
NPI:1053536623
Name:GRIER, DIANE SUE (MED)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:SUE
Last Name:GRIER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MS
Other - First Name:DIANE
Other - Middle Name:SUE
Other - Last Name:KEFFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS OTR
Mailing Address - Street 1:9611 KNOX DRIVE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212
Mailing Address - Country:US
Mailing Address - Phone:913-894-9640
Mailing Address - Fax:
Practice Address - Street 1:9620 METCALF
Practice Address - Street 2:SUITE M
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-2996
Practice Address - Country:US
Practice Address - Phone:913-383-9014
Practice Address - Fax:913-383-9015
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS1700118225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics