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General NPI Number Information
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NPI Number | 1932026325
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Entity Type | Individual
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Provider Name | SYDNEY JO CARLISLE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 2 HARBOR BEND CT STE 102
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City | LAKE ST LOUIS
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State | MO
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Zip | 63367-1480
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Country | US
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Telephone | 636-695-2075
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Fax |
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Provider Business Mailing Address
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Address Line | 860 GLEN EAGLE DR
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City | TROY
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State | MO
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Zip | 63379-3577
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Country | US
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Telephone | 217-430-9729
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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 | 2026029098
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License Number State | MO
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