Organization
JENNIFER GANDOLFO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER M GANDOLFO OTR/L (OCCUPATIONAL THERAPIST)
(314) 440-8985
Entity
Organization
Contact information
Practice address
710 ABBOTTSFORD CT., LAKE ST. LOUIS, MO 63367
(314) 479-0306
Mailing address
710 ABBOTTSFORD CT., LAKE ST. LOUIS, MO 63367
(314) 479-0306
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/21/2016
Last updated
03/21/2016
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