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Individual

MRS. LEA MARIE HOLLENBECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT/L

Contact information

Practice address
235 DENNISON DR, BALLWIN, MO 63021-4801
(636) 222-2782
Mailing address
235 DENNISON DR, BALLWIN, MO 63021-4801
(636) 222-2782

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2007026641
MO
225X00000X
Occupational Therapist
5960
CA

Other

Enumeration date
06/19/2008
Last updated
06/19/2008
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