Individual
SANDRA K LONERGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5816 HIGHWAY 54, SUITE 103A, OSAGE BEACH, MO 65065-3046
(573) 348-4004
Mailing address
PO BOX 3585, CAMDENTON, MO 65020-3585
(573) 823-1859
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2010017544
MO
Other
Enumeration date
06/14/2010
Last updated
06/14/2010
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