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NPI Code Detail

MEDICARE: LEA MARIE DAMRELL OTR/L

MEDICARE:   LEA MARIE DAMRELL  OTR/L
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
1225XP0200XPediatric Occupational Therapist2007027735MO

General Provider Information

NPI Number : 1548499247
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEA MARIE DAMRELL OTR/L
Provider Business Mailing Address
First Line : 115 FRANCIS CT
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-5901
Country : US
Telephone Number : 314-315-3344
Fax Number :
Provider Business Practice Location Address
First Line : 324 JUNGERMANN RD
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-5350
Country : US
Telephone Number : 636-928-5327
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2009
Last Update Date : 07/02/2009

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Directions to “ LEA MARIE DAMRELL OTR/L” Practice Location

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