Individual
MISS MIA LOREN SALAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1010 AVALON ST APT 11, TRENTON, MO 64683-2697
(660) 988-7186
Mailing address
1010 AVALON ST APT 11, TRENTON, MO 64683-2697
(660) 988-7186
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2023047363
MO
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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