Provider Demographics
NPI:1699326355
Name:KOECHNER, LAYNE MILLER
Entity type:Individual
Prefix:
First Name:LAYNE
Middle Name:MILLER
Last Name:KOECHNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14500 E 42ND ST S STE 220
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-4700
Mailing Address - Country:US
Mailing Address - Phone:816-478-7800
Mailing Address - Fax:816-478-7839
Practice Address - Street 1:14500 E 42ND ST S STE 220
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-4700
Practice Address - Country:US
Practice Address - Phone:816-478-7800
Practice Address - Fax:816-478-7839
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018032395224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant