Individual
MS. WENDI LAGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
805 TOMMY RATZLAFF AVE, GREEN FOREST, AR 72638-2911
(870) 438-5201
(870) 438-6214
Mailing address
PO BOX 1950, GREEN FOREST, AR 72638-1950
(870) 438-5201
(870) 438-6214
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2013033612
MO
Other
Enumeration date
02/25/2014
Last updated
02/25/2014
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