Individual
MIRANDA RENAE GREGIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
701 S 8TH ST, CLINTON, MO 64735-2901
(573) 825-2072
Mailing address
400 W SOUTH ST APT H, WARRENSBURG, MO 64093-2193
(573) 825-2072
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2023044115
MO
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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