Individual
MARY MCCANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 WYNDCREST CT, LAKE ST LOUIS, MO 63367-4368
(314) 852-6279
Mailing address
105 WYNDCREST CT, LAKE ST LOUIS, MO 63367-4368
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2015039041
MO
Other
Enumeration date
05/03/2017
Last updated
07/26/2024
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