Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 003597 | MO |
NPI | 1134740178 |
---|---|
Provider Name | Mrs. Rachel Lea Compere |
First Address | Springfield, MO 65807-7310 |
Second Address | Springfield, MO 65807-7310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2020 |
Last Update Date | 30/04/2020 |