MEDICARE: MRS. ANDREA ELIZABETH HORSFORD OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	004534	MO

General Provider Information

NPI Number	:	1114209061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANDREA ELIZABETH HORSFORD OTR

Provider Business Mailing Address
First Line	:	7733 FORSYTH BLVD
Second Line	:	SUITE 2300
City	:	SAINT LOUIS
State	:	MO
Zip	:	63105-1817
Country	:	US
Telephone Number	:	180-067-7120
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 W OUTER 21 RD
Second Line	:
City	:	ARNOLD
State	:	MO
Zip	:	63010-4644
Country	:	US
Telephone Number	:	636-296-9200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2011
Last Update Date	:	09/16/2011

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