Individual
TARA HAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
54 THE LEGENDS PKWY STE 157, EUREKA, MO 63025-3803
(636) 252-4464
Mailing address
4041 CHOUTEAU AVE APT 122, SAINT LOUIS, MO 63110-1738
(732) 216-6745
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225X00000X
Occupational Therapist
2024049372
MO
225XP0200X
Pediatric Occupational Therapist
Primary
2024049372
MO
Other
Enumeration date
02/13/2020
Last updated
03/18/2026
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