Individual
MRS. KATHLEEN LOUISE WIEGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6768 N US HIGHWAY 67, FLORISSANT, MO 63034-2742
(314) 413-3657
Mailing address
39 PILOT HILL DR, SAINT PETERS, MO 63376-2739
(636) 922-2656
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
2007016351
MO
314000000X
Skilled Nursing Facility
Primary
2007016351
MO
Other
Enumeration date
05/20/2008
Last updated
05/20/2008
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