Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 2007036006 | MO |
NPI | 1023246568 |
---|---|
Provider Name | Marie Elizabeth Barba |
First Address | Saint Louis, MO 63141-0238 |
Second Address | Kansas City, MO 64151-1057 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 23/06/2009 |