Individual
MRS. MCKENSEY MARIE WHITCHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2275 SOMMERS RD, LAKE ST LOUIS, MO 63367-6406
(636) 561-0075
Mailing address
1148 HOFF RD, SAINT PAUL, MO 63366-1936
(163) 629-3573
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2020035410
MO
Other
Enumeration date
07/23/2022
Last updated
07/23/2022
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