Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 004321 | MO |
NPI | 1003926130 |
---|---|
Provider Name | Ms. Ann Heath Pietroburgo |
First Address | Kirkwood, MO 63122 |
Second Address | St Louis, MO 63116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |