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NPI Code Detail

MEDICARE: BRENDA KAY ALLIN

MEDICARE:   BRENDA KAY ALLIN
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
1224Z00000XOccupational Therapy Assistant

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1004373OTHERMOLICENSE #

General Provider Information

NPI Number : 1477513687
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA KAY ALLIN
Provider Business Mailing Address
First Line : 1321 CLIFFRIDGE LN
Second Line :
City : VALLEY PARK
State : MO
Zip : 63088-1172
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13537 BARRETT PARKWAY DR
Second Line : STE 200
City : MANCHESTER
State : MO
Zip : 63021-5899
Country : US
Telephone Number : 314-966-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 07/08/2007

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Directions to “ BRENDA KAY ALLIN ” Practice Location

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