Individual
SHANNON THARP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1531 NEBRASKA ST, MOUND CITY, MO 64470-1610
(660) 442-5477
Mailing address
302 QUALITY ROW, WATSON, MO 64496-8410
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2004001983
MO
Other
Enumeration date
05/11/2007
Last updated
07/30/2007
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