Individual
STACEY MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
801 N 11TH ST, MEDICAID DEPARTMENT, SAINT LOUIS, MO 63101-1015
(314) 345-2535
(314) 345-2653
Mailing address
18 EAGLES LANDING DR, SAINT PETERS, MO 63376-4906
(636) 387-0016
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2004028412
MO
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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