Individual
MS. LISA ANN ENTWISTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
11097 SAINT CHARLES ROCK RD, SAINT ANN, MO 63074-1509
(314) 213-8100
(314) 213-8610
Mailing address
11097 SAINT CHARLES ROCK RD, SAINT ANN, MO 63074-1509
(314) 213-8100
(314) 213-8610
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
005129
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
476134507
—
MO
Enumeration date
11/17/2006
Last updated
04/16/2018
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