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Individual

MRS. KAYLA RENEE HAGEDORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT, OTR/L

Contact information

Practice address
101 BOGIE HILLS DR, COLUMBIA, MO 65201-2832
(573) 999-3166
Mailing address
101 BOGIE HILLS DR, COLUMBIA, MO 65201-2832
(573) 999-3166

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2010023528
MO
225XP0200X
Pediatric Occupational Therapist
2010023528
MO

Other

Enumeration date
08/03/2010
Last updated
01/02/2014
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