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General NPI Number Information
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NPI Number | 1629773221
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Entity Type | Individual
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Provider Name | MIKAYLA ANNE WINKLER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 4200 N CLOVERLEAF DR STE J
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City | SAINT PETERS
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State | MO
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Zip | 63376-6436
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Country | US
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Telephone | 636-922-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 BEALE ST UNIT 269
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City | SAINT CHARLES
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State | MO
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Zip | 63303-4258
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Country | US
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Telephone | 816-922-9345
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2023011527
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License Number State | MO
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