Individual
DONNA FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13230 MANCHESTER RD, DES PERES, MO 63131-1706
(314) 821-2886
Mailing address
13230 MANCHESTER RD, DES PERES, MO 63131-1706
(314) 821-2886
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2012032745
MO
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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