| NPI | 1124721998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRINA NICOLE BLACKWOOD Occupational Therapist 636-443-5379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2023-06-06 |