Individual
TIFFANY BEALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 FLEETWOOD DR, WAYNESVILLE, MO 65583-2266
(573) 842-2092
Mailing address
1017 TROUTMAN DR, LEBANON, MO 65536-4139
(417) 718-5186
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2013018791
MO
Other
Enumeration date
07/17/2025
Last updated
07/17/2025
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