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General NPI Number Information
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NPI Number | 1700424553
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Entity Type | Individual
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Provider Name | SARAH CATHLEEN GENO MOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/11/2019
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Last Update Date | 12/11/2019
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Provider Practice Location Address
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Address Line | 2407 KENTUCKY ST
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City | LOUISIANA
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State | MO
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Zip | 63353-2503
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Country | US
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Telephone | 314-882-5747
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Fax |
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Provider Business Mailing Address
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Address Line | 348 ROCKPORT DR
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City | TROY
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State | MO
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Zip | 63379-3576
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Country | US
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Telephone | 314-882-5747
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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 | 2019026145
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License Number State | MO
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