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Individual

NICOLE MCCLAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD, OTR/L

Contact information

Practice address
3420 HARRY S TRUMAN BLVD, SAINT CHARLES, MO 63301-4046
(636) 926-2700
Mailing address
3420 HARRY S TRUMAN BLVD, SAINT CHARLES, MO 63301-4046

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2021024254
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
507265809
MO
05
856118104
MO
Enumeration date
06/26/2021
Last updated
08/01/2023
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