Michelle Lynn Swyers, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Vienna, MO

NPI 1336484716 · NPPES record last updated Dec 11, 2012

Key facts

NPI
1336484716
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
2011006718 (MO)
Practice address
174 Ballpark Rd
Vienna, MO 65582-8043
Phone
(573) 422-3177
NPI assigned
Dec 11, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2011006718MOMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2011006718 MO Yes

Addresses

Primary practice location

174 Ballpark Rd
Vienna, MO 65582-8043

Mailing address

767 Highway M
Steelville, MO 65565-5019
Phone (573) 775-5639

Other providers in Vienna, MO

All providers in Vienna, MO · Occupational Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.