Individual
SHAEANA LENAE COBBINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
811 CENTER ST, FULTON, MO 65251-1922
(573) 642-6646
Mailing address
1107 W BROADWAY APT F, COLUMBIA, MO 65203-2184
(573) 881-5302
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2016013714
MO
Other
Enumeration date
11/04/2021
Last updated
11/04/2021
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