Individual
KIMBERLY SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
12335 W BEND DR, SAINT LOUIS, MO 63128-2160
(314) 435-4827
Mailing address
12400 SOMERSET PLACE DR APT L, SAINT LOUIS, MO 63128-2237
(314) 435-4827
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12345
NBCOT
MO
Enumeration date
11/21/2019
Last updated
11/21/2019
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