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General NPI Number Information
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NPI Number | 1326288929
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Entity Type | Individual
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Provider Name | ERICA J FAHRNER
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Gender | Female
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Dates
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Enumeration Date | 02/23/2009
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 6022 S. LINDBERGH, SUITE 100
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City | SAINT LOUIS
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State | MO
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Zip | 63123
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Country | US
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Telephone | 314-845-7751
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Fax |
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Provider Business Mailing Address
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Address Line | 6634 LINDENWOOD PL #1
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City | SAINT LOUIS
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State | MO
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Zip | 63109-1222
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Country | US
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Telephone | 314-283-2340
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 2001018129
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License Number State | MO
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