Individual
BROOKE RENEA TUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
405 FARMER RD, WILLARD, MO 65781-9509
(417) 742-0930
Mailing address
405 FARMER RD, WILLARD, MO 65781-9509
(417) 742-0930
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2014023548
MO
Other
Enumeration date
10/20/2023
Last updated
10/20/2023
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