Individual
BRENDA KAY THEBEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3761 E US HIGHWAY 54, LINN CREEK, MO 65052-1756
(314) 808-2955
Mailing address
3761 E US HIGHWAY 54, LINN CREEK, MO 65052-1756
(314) 808-3955
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
005389
MO
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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