Individual
GABRIELLE MARIE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11960 WESTLINE INDUSTRIAL DR, SAINT LOUIS, MO 63146-3228
(314) 439-1949
Mailing address
11960 WESTLINE INDUSTRIAL DR, SAINT LOUIS, MO 63146-3228
(314) 439-1949
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
003006
MO
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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