Individual
BRANDI LYNN MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2085 BLUESTONE DR STE 202, SAINT CHARLES, MO 63303-6727
(636) 896-0999
Mailing address
2085 BLUESTONE DR STE 202, SAINT CHARLES, MO 63303-6727
(636) 896-0999
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2017027209
MO
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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