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NPI Code Detail

MEDICARE: GRACE HEGERFELD

MEDICARE: GRACE HEGERFELD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant2023040933MO

General Provider Information

NPI Number : 1871427542
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE HEGERFELD
Provider Business Mailing Address
First Line : 12490 ARROW WOOD DR
Second Line :
City : TEBBETTS
State : MO
Zip : 65080-1445
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1501 SCHOOL RD
Second Line :
City : LAKE OZARK
State : MO
Zip : 65049-9761
Country : US
Telephone Number : 573-365-4091
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2026
Last Update Date : 06/09/2026

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Directions to “ GRACE HEGERFELD ” Practice Location

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