Provider Demographics
NPI:1023838034
Name:JENKINS, AMBER LEIGH (OTR/L)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:LEIGH
Last Name:JENKINS
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 1:11523 S LENNOX ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-6613
Mailing Address - Country:US
Mailing Address - Phone:913-706-4806
Mailing Address - Fax:
Practice Address - Street 1:24310 W 109TH TER
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-8852
Practice Address - Country:US
Practice Address - Phone:913-706-0362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000169349225X00000X
KS17-01914225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist