Individual
MRS. ANTOINETTE MARIE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
384 CHATEAUGAY LN, CHESTERFIELD, MO 63017-2849
(314) 485-1180
(314) 485-1160
Mailing address
384 CHATEAUGAY LN, CHESTERFIELD, MO 63017-2849
(314) 485-1180
(314) 485-1160
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
000915
MO
225XP0200X
Pediatric Occupational Therapist
000915
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
473528941
—
MO
Enumeration date
02/17/2007
Last updated
07/21/2022
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