IndividualActive
Audrey Gaines
NPI 1780452391 · Occupational Therapy Assistant · Fulton, MO
Provider details
- NPI number
- 1780452391
- Entity type
- Individual
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 2023039702 (MO)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
2 Hornet Dr
Fulton, MO 65251-2732
Phone: (573) 642-4632
Approximate (ZIP-level) locationGet directions
Mailing address
1240 County Road 2340
Moberly, MO 65270-4323
Registry dates
- Enumerated
- 2023-12-13
- Last updated
- 2023-12-13
- Certified
- 2023-12-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.