Jessica Renee Petty, OTR-L

Individual provider Active NPI Occupational Therapist · Labadie, MO

NPI 1356489082 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1356489082
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
MO2003003154 (MO)
Practice address
361 Meadow Crest Dr
Labadie, MO 63055-1982
Phone
(314) 520-3326
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
Yes

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
MO2003003154MOMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X MO2003003154 MO Yes

Addresses

Primary practice location

361 Meadow Crest Dr
Labadie, MO 63055-1982

Mailing address

361 Meadow Crest Dr
Labadie, MO 63055-1982
Phone (314) 520-3326

Other providers in Labadie, MO

All providers in Labadie, MO · Occupational Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.