Individual
MISS MORIAH NICOLE SUE BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
501 SE 12TH ST, OAK GROVE, MO 64075-9384
(816) 690-4153
Mailing address
1107 S SAINT LOUIS ST, CONCORDIA, MO 64020-9620
(660) 525-4566
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2023031911
MO
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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