Individual
MICHELLE BOURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14360 S OUTER 40, CHESTERFIELD, MO 63017-5710
(314) 431-5640
Mailing address
2009 BROOK HILL MANOR CT, CHESTERFIELD, MO 63017-7962
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
000532
MO
Other
Enumeration date
01/25/2009
Last updated
01/25/2009
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