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Individual

MRS. JESSIE A ELDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
214 HARTMAN PL STE 100, SAINT CLAIR, MO 63077-2458
(636) 629-6161
Mailing address
4601 BERGAMOT DR, HILLSBORO, MO 63050-2558
(636) 524-2876

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2017005582
MO

Other

Enumeration date
07/08/2021
Last updated
07/08/2021
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