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Individual

MRS. JENNIFER L BERRYESSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
2673 E SAWYER RD, REPUBLIC, MO 65738-7574
(417) 324-7646
Mailing address
1511 W SNIDER ST, OZARK, MO 65721-7371
(417) 827-7184

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2003014810
MO

Other

Enumeration date
01/15/2024
Last updated
01/15/2024
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