Provider Demographics
NPI:1689843336
Name:SALAPARE, MARY JO ANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARY JO ANN
Middle Name:
Last Name:SALAPARE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 W 5TH ST
Mailing Address - Street 2:D & E
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64801-2501
Mailing Address - Country:US
Mailing Address - Phone:417-782-2917
Mailing Address - Fax:417-782-7038
Practice Address - Street 1:410 STATE HIGHWAY H
Practice Address - Street 2:
Practice Address - City:MINER
Practice Address - State:MO
Practice Address - Zip Code:63801-5350
Practice Address - Country:US
Practice Address - Phone:573-472-2084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006010539225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist