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Individual

AMELIA BONIFACIO CUEVAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
825 N MAIN ST, CLEARWATER R-I, PIEDMONT, MO 63957-1222
(573) 223-4812
(573) 223-7820
Mailing address
825 N MAIN ST, PIEDMONT, MO 63957-1222
(573) 223-4812
(573) 223-7820

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
002357
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
473977528
MO
Enumeration date
05/10/2007
Last updated
02/23/2009
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