MEDICARE: CIARA COLEMAN OTR/L

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	2017004460	MO

General Provider Information

NPI Number	:	1194688242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIARA COLEMAN OTR/L

Provider Business Mailing Address
First Line	:	105 S CENTRAL AVE
Second Line	:
City	:	CLAYTON
State	:	MO
Zip	:	63105-1772
Country	:	US
Telephone Number	:	314-615-2974
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 S CENTRAL AVE
Second Line	:
City	:	CLAYTON
State	:	MO
Zip	:	63105-1772
Country	:	US
Telephone Number	:	314-615-2974
Fax Number	:

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

Provider Enumeration Date	:	12/05/2025
Last Update Date	:	12/05/2025

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Directions to “ CIARA COLEMAN OTR/L” Practice Location

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