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Individual

ALISA ANN WILLINGHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
142 SHELBY PLAZA RD, SHELBINA, MO 63468-1065
(573) 588-4175
(573) 588-2011
Mailing address
142 SHELBY PLAZA RD, SHELBINA, MO 63468-1065
(573) 588-4175
(573) 588-2011

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2008021287
MO

Other

Enumeration date
07/13/2010
Last updated
07/13/2010
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