Individual
GRACIE LYNN COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1800 WEIN ST, HERMANN, MO 65041-1601
(573) 486-3155
Mailing address
608 N 2ND ST, WELLSVILLE, MO 63384-1102
(573) 220-5544
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2022045496
MO
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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