Individual
GINA BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
450 N LINDBERGH BLVD, CREVE COEUR, MO 63141-7814
(314) 356-2098
Mailing address
12819 HASBROOK DR, SAINT LOUIS, MO 63146-3705
(314) 216-1022
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2021035617
MO
Other
Enumeration date
12/23/2021
Last updated
12/23/2021
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