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Individual

MS. STACIE L LUTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
4921 PARKVIEW PL, DEPT OCCUPATIONAL THERAPY, STE 6F, SAINT LOUIS, MO 63110-1032
(314) 286-1669
(314) 747-3662
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 286-1669
(314) 747-3662

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2002002536
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
470138987
MO
Enumeration date
11/02/2011
Last updated
04/17/2025
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