Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 2016036932 | MO |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 2016036932 | MO |
NPI | 1023533312 |
---|---|
Provider Name | Ms. Jeanette M Seitrich |
First Address | Saint Louis, MO 63131-2516 |
Second Address | Saint Louis, MO 63136-5418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2017 |
Last Update Date | 26/04/2019 |