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Individual

JACQUELINE FOOTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
202 E MILL ST, HUMANSVILLE, MO 65674-8507
(417) 754-1601
Mailing address
206 W LEE ST, BUTLER, MO 64730-1130
(660) 227-9007

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
003149
MO
224Z00000X
Occupational Therapy Assistant
1517
CA
224Z00000X
Occupational Therapy Assistant
210437
TX

Other

Enumeration date
07/03/2009
Last updated
07/03/2009
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