Provider Demographics
NPI:1679552541
Name:JANSSEN, TAMARA DAWN (OTR/L CHT)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:DAWN
Last Name:JANSSEN
Suffix:
Gender:F
Credentials:OTR/L CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 PAWNEE DR
Mailing Address - Street 2:
Mailing Address - City:ROELAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66205-1547
Mailing Address - Country:US
Mailing Address - Phone:913-789-7294
Mailing Address - Fax:
Practice Address - Street 1:4460 S NOLAND RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-4743
Practice Address - Country:US
Practice Address - Phone:816-373-2845
Practice Address - Fax:816-373-2842
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999142616225XH1200X
KS1701826225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand