Provider Demographics
NPI:1396323937
Name:BAMFORD, ALLISON LOUISE (OTR/L)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LOUISE
Last Name:BAMFORD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3491
Mailing Address - Country:US
Mailing Address - Phone:816-931-4277
Mailing Address - Fax:
Practice Address - Street 1:4301 MADISON AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3491
Practice Address - Country:US
Practice Address - Phone:816-931-4277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-03844225X00000X
MO2021006961225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist