Individual
DOROTHY ALICE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1202 HEARTLAND RD, SAINT JOSEPH, MO 64506-3492
(816) 671-8506
Mailing address
208 MICHIGAN AVE, SAINT JOSEPH, MO 64504-1535
(816) 238-4618
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004052
MO
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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