Individual
LAUREN SOUDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L, CBIS, CSRS
Contact information
Practice address
4455 DUNCAN AVE, SAINT LOUIS, MO 63110-1111
(314) 658-3800
Mailing address
701 BOBWHITE CIR, O FALLON, IL 62269-3108
(618) 977-9426
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056.009124
IL
225X00000X
Occupational Therapist
Primary
2010027444
MO
Other
Enumeration date
10/01/2011
Last updated
07/27/2020
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