Individual
MRS. MELISSA GAGNEPAIN WILSONHOLME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2516
(314) 989-8100
Mailing address
812 LE MAISSON DR, FERGUSON, MO 63135-1360
(314) 322-8235
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2008002680
MO
225X00000X
Occupational Therapist
OT11143
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
830078000
—
FL
Enumeration date
01/11/2007
Last updated
09/22/2016
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