Denise Marie Hillis, COTA

Individual provider Active NPI Occupational Therapy Assistant · Fredericktown, MO

NPI 1659569242 · NPPES record last updated Oct 9, 2007

Key facts

NPI
1659569242
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
2005018055 (MO)
Practice address
105 Spruce St
Fredericktown, MO 63645-1002
Phone
(573) 783-3993
NPI assigned
Oct 9, 2007
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
2005018055MOMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2005018055 MO Yes

Addresses

Primary practice location

105 Spruce St
Fredericktown, MO 63645-1002

Mailing address

105 Spruce St
Fredericktown, MO 63645-1002
Phone (573) 783-3993

Other providers in Fredericktown, MO

All providers in Fredericktown, MO · Occupational Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.