Provider Demographics
NPI:1699396887
Name:KOOPS, EMILY JOY (MOTR/L)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JOY
Last Name:KOOPS
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 W OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-9224
Mailing Address - Country:US
Mailing Address - Phone:816-678-7377
Mailing Address - Fax:816-678-7377
Practice Address - Street 1:504 W OLIVE ST
Practice Address - Street 2:
Practice Address - City:RAYMORE
Practice Address - State:MO
Practice Address - Zip Code:64083-9224
Practice Address - Country:US
Practice Address - Phone:816-678-7377
Practice Address - Fax:816-678-7377
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-04426225X00000X
MO2024040938225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist