Teresa Christina Waggoner COTA/L

NPI 1053627075 - Occupational Therapy Assistant - 224Z00000X

NPI Details
NPI 1053627075
Gender Female
Enumeration Date 08/27/2010
Last Updated 08/27/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
201 S NORTHPARK LN
JOPLIN MO, 64801-8426, US
Phone (417) 623-4313
Fax (417) 621-0129
Business Location
201 S NORTHPARK LN
JOPLIN MO, 64801-8426, US
Phone (417) 623-4313
Fax (417) 621-0129
Toxanomy
Taxonomy Code 224Z00000X
License State Missouri
License Number 2010019101
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According to our database, Mrs. Teresa Christina Waggoner COTA/L NPI is 1053627075, taxonomy code is 224Z00000X and license number is 2010019101, license state is located at Missouri. Teresa Christina Waggoner COTA/L physically located at 201 S Northpark Ln, Joplin MO, 64801-8426. NPI Number Teresa Christina Waggoner COTA/L has the Individual type.

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1053627075 NPI number is provided on an as is basis without warranty of any kind. 1053627075 is maintained by the National Plan & Provider Enumeration System. The contents of Teresa Christina Waggoner COTA/L are for informational purposes only.