Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 2019002275 | MO |
NPI | 1003451980 |
---|---|
Provider Name | Hannah Florence |
First Address | Saint Louis, MO 63139-2125 |
Second Address | Saint Louis, MO 63108-1807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2019 |
Last Update Date | 14/11/2019 |