Provider Demographics
NPI:1538853676
Name:RAULS, SONDRA L
Entity type:Individual
Prefix:
First Name:SONDRA
Middle Name:L
Last Name:RAULS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4874
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64803-4874
Mailing Address - Country:US
Mailing Address - Phone:314-804-9798
Mailing Address - Fax:
Practice Address - Street 1:17868 HAWTHORNE RD
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-8608
Practice Address - Country:US
Practice Address - Phone:314-804-9798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOTA0000004101224Z00000X
NMOT-2025-0039224Z00000X
MTOTP-OTA-LIC-11512224Z00000X
MO2015023350224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant