Individual
MISS TRINITI GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
704 W 13TH TER, CARROLLTON, MO 64633-1512
(660) 542-4435
Mailing address
704 W 13TH TER, CARROLLTON, MO 64633-1512
(660) 542-4435
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2023038605
MO
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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