Individual
MARISA BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11960 WESTLINE INDUSTRIAL DR, SAINT LOUIS, MO 63146-3228
(314) 629-5476
Mailing address
12415 BALLAS TRAILS DR, SAINT LOUIS, MO 63122-2145
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
11/09/2018
Last updated
11/09/2018
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