Individual
TAMMY WOODBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
111 NW MOCK AVE STE OFF, BLUE SPRINGS, MO 64014-2504
(816) 228-5655
Mailing address
2023 NE COOKSON ST, LEES SUMMIT, MO 64086-6307
(816) 446-7646
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2004016782
MO
Other
Enumeration date
02/11/2019
Last updated
02/11/2019
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