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Individual

BETH ANN DAMKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1 VILLAGE SQUARE CTR STE A, HAZELWOOD, MO 63042-1817
(314) 731-4555
(314) 557-6110
Mailing address
942 SCOTCH PINE TRL, FORISTELL, MO 63348-1522
(314) 566-0282

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2009014390
MO

Other

Enumeration date
08/21/2010
Last updated
08/21/2010
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