| NPI | 1104969211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE MARIE GASSIRARO Registered Occupational Therapist 618-659-0959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 003239) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |