Individual
CHARLA FAYE HOLST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
409 W LOCUST ST, AURORA, MO 65605-1422
(417) 678-3373
(417) 678-4043
Mailing address
409 W LOCUST ST, AURORA, MO 65605-1422
(417) 678-3373
(417) 678-4043
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1999134935
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
476914106
—
MO
Enumeration date
02/27/2007
Last updated
02/19/2009
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