Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 2006026899 | MO |
N | 225XP0200X | Occupational Therapist - Pediatrics | 2006026899 | MO |
NPI | 1033253273 |
---|---|
Provider Name | Miss Lyndsey Elaine Boyer |
First Address | Saint Charles, MO 63301-8198 |
Second Address | Saint Louis, MO 63131-1706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2007 |
Last Update Date | 22/05/2014 |