Individual
ANDREA KINCADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 RENFREW LN S, O FALLON, MO 63366-4582
(678) 665-1563
Mailing address
1100 RENFREW LN S, O FALLON, MO 63366-4582
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2021050217
MO
224Z00000X
Occupational Therapy Assistant
OTA002360
GA
Other
Enumeration date
12/14/2021
Last updated
01/04/2022
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