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1093054249
LICATA JEANE WILSON
WEST PLAINS, MO
NPI
1093054249
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: MO 2008023618)
Enumeration Date
2013-02-07
Last Update Date
2013-02-07
Business Address
-- LICATA JEANE WILSON
210 DAVIS DR
WEST PLAINS, MO 65775-2241
Phone number: 417-256-2152
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Mailing Address
-- LICATA JEANE WILSON
210 DAVIS DR
WEST PLAINS, MO 65775-2241
Phone number:
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