Individual
AUDREY MARIE GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 HORNET DR, FULTON, MO 65251-2732
(573) 642-4632
Mailing address
1240 COUNTY ROAD 2340, MOBERLY, MO 65270-4323
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2023039702
MO
Other
Enumeration date
12/13/2023
Last updated
12/13/2023
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