Individual
MISS JHARRY ANN SANTOS GUMABON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1 PARK DR STE A, HOLIDAY ISLAND, AR 72631-9405
(479) 363-6422
Mailing address
115 GLENWOOD CIR, CASSVILLE, MO 65625-4101
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1227
AR
Other
Enumeration date
08/16/2017
Last updated
08/16/2017
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