Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 2004019052 | MO |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 2004019052 | MO |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 2004019052 | MO |
NPI | 1013382886 |
---|---|
Provider Name | Katherine Rummel |
First Address | Saint Louis, MO 63128-2160 |
Second Address | Saint Louis, MO 63128-2160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2015 |
Last Update Date | 04/12/2015 |