Individual
MS. BROOKE VANDOREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1483 DARTMOUTH DR, SAINT CHARLES, MO 63303-3662
(618) 210-2885
Mailing address
1483 DARTMOUTH DR, SAINT CHARLES, MO 63303-3662
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2010012599
MO
Other
Enumeration date
11/09/2010
Last updated
11/09/2010
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