Individual
BRITNI J WALLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2061 PEAR TREE CT, APT 5, CAPE GIRARDEAU, MO 63701-2111
(618) 593-9218
(573) 472-0409
Mailing address
P.O. BOX 608, SIKESTON, MO 63801-0608
(573) 472-0397
(573) 472-0409
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011006
IL
225X00000X
Occupational Therapist
2011023399
MO
Other
Enumeration date
08/10/2011
Last updated
03/07/2024
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