MEDICARE: CATHERINE GENETTI OTRL

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	225XP0200X	Pediatric Occupational Therapist		IL

General Provider Information

NPI Number	:	1154536670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE GENETTI OTRL

Provider Business Mailing Address
First Line	:	8819 LAWN AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63144-1705
Country	:	US
Telephone Number	:	314-961-6151
Fax Number	:

Provider Business Practice Location Address
First Line	:	8819 LAWN AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63144-1705
Country	:	US
Telephone Number	:	314-961-6151
Fax Number	:

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/08/2007

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Directions to “ CATHERINE GENETTI OTRL” Practice Location

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