Healthcare Provider Details

I. General information

NPI: 1154243053
Provider Name (Legal Business Name): REBECCA SPINELLI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 BELL RD
WRIGHT CITY MO
63390-3202
US

IV. Provider business mailing address

19324 FAIRLANE CIR
WARRENTON MO
63383-4758
US

V. Phone/Fax

Practice location:
  • Phone: 636-745-7200
  • Fax:
Mailing address:
  • Phone: 636-219-9979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2022011835
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: