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NPI Code Detail

MEDICARE: ELIZABETH VICTORIA ROHDE OTR/L

MEDICARE: ELIZABETH VICTORIA ROHDE 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
1225X00000XOccupational Therapist2018024328MO

General Provider Information

NPI Number : 1518434356
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH VICTORIA ROHDE OTR/L
Provider Business Mailing Address
First Line : 4487 FORDER RIDGE DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63129-7126
Country : US
Telephone Number : 314-608-0468
Fax Number :
Provider Business Practice Location Address
First Line : 4624 LANSDOWNE AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63116-1523
Country : US
Telephone Number : 314-351-6888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2018
Last Update Date : 10/30/2018

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