Leslie G Anderson

Individual provider Active NPI Occupational Therapist · Clinton, MO

NPI 1508104233 · NPPES record last updated Sep 20, 2016

Key facts

NPI
1508104233
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
2011022939 (MO)
Practice address
1600 N 2ND St
Clinton, MO 64735-1192
Phone
(660) 885-5511
NPI assigned
Jan 31, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2011022939MOMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2011022939 MO Yes

Addresses

Primary practice location

1600 N 2ND St
Clinton, MO 64735-1192

Mailing address

1600 N 2ND St
Clinton, MO 64735-1192
Phone (660) 885-5511

Other providers in Clinton, MO

All providers in Clinton, MO · Occupational Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.