Individual
KENNEDY NEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1177 N WARSON RD, SAINT LOUIS, MO 63132-1800
(314) 569-2211
Mailing address
7816 STANFORD AVE, SAINT LOUIS, MO 63130-3610
(816) 263-0941
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2019036581
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00
—
MO
Enumeration date
09/30/2020
Last updated
09/30/2020
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