Healthcare Provider Details

I. General information

NPI: 1154477495
Provider Name (Legal Business Name): ANN MARIE CAHILL OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 SUNSET LN
KIRKWOOD MO
63122-2907
US

IV. Provider business mailing address

2 SUNSET LN
KIRKWOOD MO
63122-2907
US

V. Phone/Fax

Practice location:
  • Phone: 314-822-2735
  • Fax:
Mailing address:
  • Phone: 314-822-2735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number004802
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: