Individual
MARY SWENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5400 EXECUTIVE CENTRE PKWY, SAINT PETERS, MO 63376-2594
(636) 922-7600
Mailing address
37 SILENT BROOK CT, LAKE SAINT LOUIS, MO 63367-2610
(314) 368-2906
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2016030987
MO
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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