Individual
DAKOTA JAIE NIESSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1001 S KIRKWOOD RD STE 150, SAINT LOUIS, MO 63122-7251
(314) 821-7554
Mailing address
8701 NEIER LN, AFFTON, MO 63123-3445
(805) 705-9334
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2023010536
MO
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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