Individual
REBECCA FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6929 WISE AVE, SAINT LOUIS, MO 63139-3731
(314) 297-8008
(314) 530-0315
Mailing address
6929 WISE AVE, SAINT LOUIS, MO 63139-3731
(314) 297-8008
(314) 530-0315
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2017044641
MO
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
2017044641
MO
225XP0200X
Pediatric Occupational Therapist
2017044641
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470052186
—
MO
Enumeration date
03/26/2018
Last updated
11/11/2020
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