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General NPI Number Information
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NPI Number | 1437466729
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Entity Type | Individual
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Provider Name | CATHY MCCREDIE MHS, PT, OCS, MTC
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Gender | Female
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 830 WELLESLEY PLACE DR
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City | CHESTERFIELD
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State | MO
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Zip | 63017-0745
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Country | US
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Telephone | 636-530-9061
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Fax | 636-519-1909
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Provider Business Mailing Address
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Address Line | 830 WELLESLEY PLACE DR
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City | CHESTERFIELD
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State | MO
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Zip | 63017-0745
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Country | US
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Telephone | 636-530-9061
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Fax | 636-519-1909
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | R0903
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License Number State | MO
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