Individual
ELIZABETH ANNE SOPHIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
8707 PARK CRESTWOOD DR, SAINT LOUIS, MO 63126-3703
(530) 902-3955
Mailing address
8707 PARK CRESTWOOD DR, SAINT LOUIS, MO 63126-3703
(530) 902-3955
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2015024229
MO
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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