Individual
MRS. JANE M. BALEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
509 MEADOWLARK AVE, CRANE, MO 65633-9317
(417) 723-5281
Mailing address
509 MEADOWLARK AVE, CRANE, MO 65633-9317
(417) 723-5281
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2009017037
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2009017037
COTA LICENSE MO
MO
Enumeration date
03/23/2010
Last updated
03/23/2010
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