Individual
MRS. STACEY DIANN CHILDERS-TEEPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1480 8TH ST, WEST PLAINS, MO 65775-2010
(417) 256-5669
(417) 256-5699
Mailing address
RR 2 BOX 2445, DORA, MO 65637-9306
(417) 261-2210
(417) 261-2210
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2001033005
MO
Other
Enumeration date
07/09/2006
Last updated
07/08/2007
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