Individual
SHAKIA LASHA DUPREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
117 VENTURA AVENUE APT. 11, JEFFERSON CITY, MO 65109-0595
(314) 550-9925
Mailing address
117 VENTURA AVE APT 11, JEFFERSON CITY, MO 65109-0595
(314) 550-9925
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2011012150
MO
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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