Individual
ANGELA MARIE FOREST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
410 W BENTON ST, MONETT, MO 65708-1608
(417) 235-3049
Mailing address
1125 W MOUNT VERNON ST, SPRINGFIELD, MO 65806-1647
(417) 812-0394
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2007016456
MO
Other
Enumeration date
07/11/2007
Last updated
10/12/2012
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