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Individual

CLARISSA IBARRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1600 ELY ST, KENNETT, MO 63857-1340
(573) 717-1115
Mailing address
1899 N WESTWOOD BLVD STE C, POPLAR BLUFF, MO 63901-2834
(573) 772-0832

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2023000208
MO

Other

Enumeration date
02/26/2024
Last updated
02/26/2024
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