Individual
TINA MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3625 MAGNOLIA AVE, SAINT LOUIS, MO 63110-4048
(314) 771-2990
Mailing address
2740 GRANDVIEW AVE, ALTON, IL 62002-1812
(618) 593-0283
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2010007275
MO
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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