Provider Demographics
NPI:1982401626
Name:MORAN, CHERI RENEE (COTA/L)
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:RENEE
Last Name:MORAN
Suffix:
Gender:
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 S WALKER ST
Mailing Address - Street 2:
Mailing Address - City:WEBB CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64870-2755
Mailing Address - Country:US
Mailing Address - Phone:417-438-2081
Mailing Address - Fax:
Practice Address - Street 1:418 FAIRGROUND RD
Practice Address - Street 2:
Practice Address - City:NEOSHO
Practice Address - State:MO
Practice Address - Zip Code:64850-1626
Practice Address - Country:US
Practice Address - Phone:417-451-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023004807224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant