Jennifer Larae Clemons, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Cameron, MO
NPI 1467723775 · NPPES record last updated Jan 18, 2012
Key facts
- NPI
- 1467723775
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 1999140351 (MO)
- Practice address
- 1010 W Prospect St
Cameron, MO 64429-2051 - Phone
- (816) 632-7498
- NPI assigned
- Jan 18, 2012
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1999140351 | MO | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1999140351 | MO | Yes |
Addresses
Primary practice location
1010 W Prospect St
Cameron, MO 64429-2051
Mailing address
1010 W Prospect St
Cameron, MO 64429-2051
Phone (816) 288-1774
Other providers in Cameron, MO
- Cristi Campbell
- Richard D Campbell
- Mark Landis Carr
- Charles E Chatfield
- Clay Poplin LCSW, LLC
- Clinco Sheltered Industries, Inc.
- Marci Rhea Cline
- Abby Coles-Johnson
- Guy A Corazzin
- Bonnie Lou Cox
All providers in Cameron, MO · 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 Jan 18, 2012. 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.