Individual
ELYSE NICOLE WINGBERMUEHLE
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
1505 PROSPECTOR TRL, WENTZVILLE, MO 63385-4925
(573) 590-0237
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2010031848
MO
Other
Enumeration date
07/05/2019
Last updated
07/05/2019
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