Provider Demographics
NPI:1962658294
Name:URSAIS, PEARLIE (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:PEARLIE
Middle Name:
Last Name:URSAIS
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 1:4052 W SIERRA ST
Mailing Address - Street 2:
Mailing Address - City:BATTLEFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65619-8246
Mailing Address - Country:US
Mailing Address - Phone:417-693-3971
Mailing Address - Fax:
Practice Address - Street 1:509 MEADOWLARK AVE
Practice Address - Street 2:
Practice Address - City:CRANE
Practice Address - State:MO
Practice Address - Zip Code:65633-9317
Practice Address - Country:US
Practice Address - Phone:417-723-5281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2000173514OtherOCCUPATIONAL THERAPY LICENSE