Individual provider · NPI-1

Susan Elizabth Ault, Cota/l

Occupational Therapy Assistant · Saint Louis, MO

NPI number1376889626
StatusActive
Last updated in NPPESDec 13, 2012

Details

NPI
1376889626
Entity type
Individual (NPI-1)
Name
Ms. Susan Elizabth Ault
Credential
Cota/l
Sex
Female
Sole proprietor
Yes
Enumeration date
Dec 13, 2012
Last updated
Dec 13, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
224Z00000X Occupational Therapy Assistant004686MOYes

Practice location

12346 Rossridge Ct
Saint Louis, MO 63146-4607

Phone 314-288-7478

Mailing address

12346 Rossridge Ct
Saint Louis, MO 63146-4607

Phone 314-288-7478

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