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NPI Code Detail

MEDICARE: STEPHANIE ANN HARRISON MOTR/L

MEDICARE: STEPHANIE ANN HARRISON MOTR/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 Therapist2007009355MO

General Provider Information

NPI Number : 1568661494
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE ANN HARRISON MOTR/L
Provider Business Mailing Address
First Line : 10600 LEWIS AND CLARK BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63136-6005
Country : US
Telephone Number : 314-340-6389
Fax Number : 314-869-8074
Provider Business Practice Location Address
First Line : 10600 LEWIS AND CLARK BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63136-6005
Country : US
Telephone Number : 314-340-6389
Fax Number : 314-869-8074
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2007
Last Update Date : 08/20/2008

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Directions to “ STEPHANIE ANN HARRISON MOTR/L” Practice Location

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