Organization
BELLA LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAQUELINE MARIA SHAFER OTR/L (OCCUPATIONAL THERAPIST)
(314) 914-5000
Entity
Organization
Contact information
Practice address
105 BONNYBRIDGE CT, ELLISVILLE, MO 63021-4507
(314) 914-5000
Mailing address
105 BONNYBRIDGE CT, ELLISVILLE, MO 63021-4507
(314) 914-5000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
005080
MO
225XE0001X
Environmental Modification Occupational Therapist
Primary
005080
MO
225XE1200X
Ergonomics Occupational Therapist
005080
MO
225XG0600X
Gerontology Occupational Therapist
005080
MO
225XP0019X
Physical Rehabilitation Occupational Therapist
005080
MO
225XP0200X
Pediatric Occupational Therapist
005080
MO
Other
Enumeration date
10/02/2017
Last updated
10/02/2017
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