Individual
MS. SUSAN ELIZABTH AULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
12346 ROSSRIDGE CT, SAINT LOUIS, MO 63146-4607
(314) 288-7478
Mailing address
12346 ROSSRIDGE CT, SAINT LOUIS, MO 63146-4607
(314) 288-7478
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004686
MO
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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