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General NPI Number Information
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NPI Number | 1801676846
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Entity Type | Individual
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Provider Name | JENNIFER BACH OTD, OTR/L, CLVT
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Gender | Female
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 1 JEFFERSON BARRACKS DRIVE LOW VISION CLINIC, ROOM 1A-110
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City | SAINT LOUIS
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State | MO
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Zip | 63125-4199
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Country | US
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Telephone | 314-652-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 8310 MAYLOR DR
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City | SAINT LOUIS
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State | MO
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Zip | 63123-3442
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Country | US
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Telephone |
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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 | 2255R0406X
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Taxonomy Name | Blind Rehabilitation Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XL0004X
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Taxonomy Name | Low Vision Occupational Therapist
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License Number | 2010008354
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License Number State | MO
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