Provider Demographics
NPI:1548472608
Name:FORNELLI, JONI UNRUH (OTR)
Entity type:Individual
Prefix:MS
First Name:JONI
Middle Name:UNRUH
Last Name:FORNELLI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2547 ARKANSAS ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-4533
Mailing Address - Country:US
Mailing Address - Phone:785-843-3492
Mailing Address - Fax:
Practice Address - Street 1:1501 INVERNESS DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-1870
Practice Address - Country:US
Practice Address - Phone:785-838-8000
Practice Address - Fax:785-838-8972
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-00474225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist