Basic Information
Provider Information
NPI: 1356703854
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLEK
FirstName: JONI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WARNER
OtherFirstName: JONI
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: OTR/L
OtherLastNameType: 1
Mailing Information
Address1: 4801 E LINWOOD BLVD
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641282226
CountryCode: US
TelephoneNumber: 8168614700
FaxNumber: 8169224830
Practice Location
Address1: 4801 E LINWOOD BLVD
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641282226
CountryCode: US
TelephoneNumber: 8168614700
FaxNumber: 8169224830
Other Information
ProviderEnumerationDate: 03/23/2016
LastUpdateDate: 03/23/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X2009013157MOY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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