Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 2009029357 | MO |
NPI | 1851575849 |
---|---|
Provider Name | Sharon Colleen Denner |
First Address | Harrisonville, MO 64701-6900 |
Second Address | Harrisonville, MO 64701-3714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2007 |
Last Update Date | 11/01/2011 |