Provider Demographics
NPI:1962733667
Name:STRICKLIN, ANDREA R (LMT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:R
Last Name:STRICKLIN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6231 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64130-3954
Mailing Address - Country:US
Mailing Address - Phone:816-606-1329
Mailing Address - Fax:
Practice Address - Street 1:1734 E 63RD ST
Practice Address - Street 2:STE 410
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3543
Practice Address - Country:US
Practice Address - Phone:816-606-1329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008034193225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist