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Individual

DEANNA LYNN MCDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LIMA,COTA

Contact information

Practice address
3863 CLEVELAND AVE, SAINT LOUIS, MO 63110-4009
(314) 664-3927
Mailing address
9950 SOLAR LN, SAINT LOUIS, MO 63123-6111
(314) 657-8879

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
2017024676
MO
247200000X
Other Technician
Primary
53499
MO

Other

Enumeration date
07/21/2017
Last updated
07/21/2017
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