Christopher Andre Beavers, COTA/L
Occupational Therapy Assistant in Saint Louis, MO. Individual provider (NPI-1).
NPI number1760743991
StatusActive
Last updated in NPPESJun 5, 2012
Details
- NPI
- 1760743991
- Entity type
- Individual (NPI-1)
- Name
- Mr. Christopher Andre Beavers
- Credential
- COTA/L
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 5, 2012
- Last updated
- Jun 5, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | 2010021288 | MO | Yes |
Practice location
4335 W Pine BlvdSaint Louis, MO 63108-2205
Phone 314-371-0200
Mailing address
4626 Whisper Lake DrFlorissant, MO 63033-4307
Phone 314-680-9510
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