Provider Demographics
NPI:1043677008
Name:SCHUTTER, KRISTINA JO (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:JO
Last Name:SCHUTTER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MRS
Other - First Name:KRISTI
Other - Middle Name:JO
Other - Last Name:SCHUTTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA/L
Mailing Address - Street 1:10318 N TRACY AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-1993
Mailing Address - Country:US
Mailing Address - Phone:816-616-5423
Mailing Address - Fax:
Practice Address - Street 1:1200 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1036
Practice Address - Country:US
Practice Address - Phone:816-781-3020
Practice Address - Fax:816-792-4043
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002196224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant