Individual
JILL DEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35629 HIGHWAY 72, SALEM, MO 65560-7217
(972) 457-1069
Mailing address
PO BOX 207, NEW MELLE, MO 63365-0207
(636) 634-0006
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2012039673
MO
Other
Enumeration date
02/16/2018
Last updated
02/16/2018
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