Individual
MRS. TESSA D FORTHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1393 BOWLES AVE, FENTON, MO 63026-2355
(636) 326-9606
Mailing address
243 KERRUISH PL, SAINT LOUIS, MO 63119-3001
(314) 452-6397
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
005056
MO
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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