Individual
MISS JENNIFER KAY HERRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
801 N 11TH ST, MEDICAID DEPARTMENT, SAINT LOUIS, MO 63101-1015
(314) 345-2535
(314) 345-2653
Mailing address
721 N MCKNIGHT RD, APT B, SAINT LOUIS, MO 63132-4931
(314) 692-2494
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2003000562
MO
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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