Individual
CAMILLE FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11960 WESTLINE INDUSTRIAL DR STE 201, SAINT LOUIS, MO 63146-3209
(866) 433-9555
Mailing address
27130 HUNT DR, WRIGHT CITY, MO 63390-4419
(314) 446-9041
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
2019017425
MO
Other
Enumeration date
07/08/2019
Last updated
10/01/2024
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