Provider Demographics
NPI:1629545090
Name:FRISBIE, ANN TERESE (DOT, MOT, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:TERESE
Last Name:FRISBIE
Suffix:
Gender:F
Credentials:DOT, MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 PARK CENTRAL SQ
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65806-1339
Mailing Address - Country:US
Mailing Address - Phone:417-612-8208
Mailing Address - Fax:
Practice Address - Street 1:1491 BUCHANAN AVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-5467
Practice Address - Country:US
Practice Address - Phone:712-898-3803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018036559225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist