Individual
JILL FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1710 N PINE ST, JOPLIN, MO 64801-6158
(417) 434-6790
Mailing address
1710 N PINE ST, JOPLIN, MO 64801-6158
(417) 434-6790
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2015044585
MO
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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