Individual
MRS. STEPHANIE ANN THIERBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
276 FOUNTAIN LN, KIMBERLING CITY, MO 65686-9356
(417) 739-2481
Mailing address
276 FOUNTAIN LN, KIMBERLING CITY, MO 65686-9356
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2001006864
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2001006864
MISSOURI BOARD OF OCCUPATIONAL THERAPY
MO
Enumeration date
07/02/2008
Last updated
07/02/2008
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