Individual
SARA SKIDMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2022 PHOENIX DRIVE, SULLIVAN, MO 63080
(636) 239-9979
(636) 239-5442
Mailing address
13537 BARRETT PARKWAY DR, SUITE 105, BALLWIN, MO 63021
(314) 821-9126
(314) 821-9142
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
004800
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00422912
PALMETTO GBA
MO
Enumeration date
09/20/2006
Last updated
12/17/2007
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