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Individual

CHARLA SALMON SHURTLEFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
332 STABLE LN, WENTZVILLE, MO 63385-5447
(636) 332-4940
Mailing address
273 COVENTRY VALLEY RD, VILLA RIDGE, MO 63089-2437
(636) 667-7028

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2001012193
MO

Other

Enumeration date
04/05/2022
Last updated
04/05/2022
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