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Individual

JACQUELINE BRINER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
3421 GASCONADE ST, SAINT LOUIS, MO 63118-4201
(314) 832-4700
Mailing address
314 ROOSEVELT ST, LEBANON, IL 62254-1441
(618) 954-9696

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057003041
IL
224Z00000X
Occupational Therapy Assistant
Primary
2008027317
MO

Other

Enumeration date
11/18/2012
Last updated
11/18/2012
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