Individual
LOREN NICOLE BOUSHEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
850 COUNTRY MANOR LN, CREVE COEUR, MO 63141-6651
(314) 434-5900
Mailing address
850 COUNTRY MANOR LN, CREVE COEUR, MO 63141-6651
(314) 434-5900
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2021012493
MO
Other
Enumeration date
09/21/2021
Last updated
09/21/2021
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