Individual
MIRANDA KOESTERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
844 CAMBRIDGE BLVD, O FALLON, IL 62269-1976
(618) 624-9900
Mailing address
2340 PARKLAND BLVD APT 15, SHILOH, IL 62269-7369
(567) 644-5678
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013548
IL
225X00000X
Occupational Therapist
2020009519
MO
Other
Enumeration date
03/31/2020
Last updated
03/31/2020
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