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Contact Information

AUDREY M GAINES
2 HORNET DR
FULTON, MO65251-2732
 Phone: 573-642-4632
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for AUDREY M GAINES · (Female)

NPI # 1780452391
Status Active
Credentials
Entity Individual
Enumeration date 12/13/2023
Last updated 12/13/2023 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2023039702
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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