Individual
BRIDGET MARY HORMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
567 N AND SOUTH RD APT C, SAINT LOUIS, MO 63130-3939
(314) 650-9288
Mailing address
567 N AND SOUTH RD APT C, SAINT LOUIS, MO 63130-3939
(314) 650-9288
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2014027319
MO
Other
Enumeration date
10/15/2014
Last updated
12/09/2019
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