IndividualActive
Patricia Kennett, COTA/L
NPI 1790064988 · Adult Care Home Facility · Republic, MO
Provider details
- NPI number
- 1790064988
- Entity type
- Individual
- Primary specialty
- Adult Care Home FacilityNursing & Custodial Care Facilities
- Credential
- COTA/L
- Sex
- Female
- Sole proprietor
- Yes
- License
- 2001017780 (MO)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
556 S Buxton Ln
Republic, MO 65738-1810
Phone: (417) 234-9174
Approximate (ZIP-level) locationGet directions
Mailing address
556 S Buxton Ln
Republic, MO 65738-1810
Registry dates
- Enumerated
- 2011-08-05
- Last updated
- 2011-08-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.