MEDICARE: VICTORIA THOMPSON MOT, OTR/L, CHES

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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1376390187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA THOMPSON MOT, OTR/L, CHES

Provider Business Mailing Address
First Line	:	3728 FRENCH AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63116-4045
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1616 CALIFORNIA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-2046
Country	:	US
Telephone Number	:	314-771-2539
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2024
Last Update Date	:	05/01/2024

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Directions to “ VICTORIA THOMPSON MOT, OTR/L, CHES” Practice Location

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