Individual
MISS SHANA PAYNE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1300 VETERANS RD, WARRENSBURG, MO 64093-8294
(660) 543-5064
Mailing address
32 NE 500TH RD, #7, WARRENSBURG, MO 64093-8266
(660) 864-3822
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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