Individual
TESSA MARIE PENICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
610 VINELAND SCHOOL RD, DE SOTO, MO 63020-2561
(636) 586-1000
(636) 586-1009
Mailing address
805 WRANGLER RDG APT 103, FESTUS, MO 63028-2684
(314) 570-9887
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2021011245
MO
Other
Enumeration date
09/12/2024
Last updated
09/12/2024
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