Individual
TANYA KREUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
104 W WASHINGTON ST, SULLIVAN, MO 63080-1965
(573) 468-5171
Mailing address
104 W WASHINGTON ST, SULLIVAN, MO 63080-1965
(573) 468-5171
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004108
MO
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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