Individual
MARY M ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
SHERBROOKE VILLAGE, 4005 RIPA AVE, ST. LOUIS, MO 63125
(314) 544-1111
Mailing address
1438 WILLOW BROOK CV APT 3, SAINT LOUIS, MO 63146-4964
(314) 303-9463
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
003366
MO
Other
Enumeration date
02/01/2019
Last updated
02/01/2019
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