Individual
MRS. MARY KATHERINE GOVERNAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.O.T.A./L
Contact information
Practice address
2 HARBOR BEND CT, LAKE ST LOUIS, MO 63367-1478
(636) 965-2070
(636) 695-2080
Mailing address
2 HARBOR BEND CT, SUITE 102, LAKE ST LOUIS, MO 63367-1478
(636) 695-2070
(636) 695-2080
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2009014323
MO
Other
Enumeration date
09/21/2010
Last updated
09/21/2010
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