Jennifer Darlene Grace
Individual provider Active NPI Environmental Modification Occupational Therapy Assistant · Fairdealing, MO
NPI 1285499210 · NPPES record last updated Feb 19, 2024
Key facts
- NPI
- 1285499210
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Environmental Modification Occupational Therapy Assistant 224ZE0001X
- Practice address
- 305 Ripley 160E-13
Fairdealing, MO 63939-8051 - Phone
- (573) 382-6828
- NPI assigned
- Feb 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Environmental Modification Occupational Therapy Assistant | 224ZE0001X | Yes |
Addresses
Primary practice location
305 Ripley 160E-13
Fairdealing, MO 63939-8051
Mailing address
305 Ripley 160E-13
Fairdealing, MO 63939-8051
Phone (573) 382-6828
Other providers in Fairdealing, MO
- Cypress Creek Residential Care LLC
- Cypress Creek, LLC
- Cypress Creek, LLC
- Holmes Enterprises, LLC
- Holmes Enterprises, LLC
- TBH Enterprises, LLC
All providers in Fairdealing, MO · Environmental Modification Occupational Therapy Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.