Individual
JOAN TABANERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2071 BARRON RD, POPLAR BLUFF, MO 63901-1903
(573) 686-1147
Mailing address
2071 BARRON RD, POPLAR BLUFF, MO 63901-1903
(573) 686-1147
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2003009981
MO
Other
Enumeration date
06/24/2014
Last updated
01/15/2024
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