Individual
JACQUELINE M DUNIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5195 MAGNOLIA DR, JOPLIN, MO 64801-6406
(417) 684-7415
Mailing address
22396 E NEBO HILL RD, NEVADA, MO 64772-8018
(417) 684-7393
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2009019115
MO
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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