Krista Ann Green, OTR

Individual provider Active NPI Occupational Therapist · Imperial, MO

NPI 1386790749 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1386790749
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
2001031019 (MO)
Practice address
5433 Redbird CV
Imperial, MO 63052-1748
Phone
(314) 566-0251
Fax
(636) 467-5738
NPI assigned
Jan 26, 2007
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
2001031019MOMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2001031019 MO Yes

Addresses

Primary practice location

5433 Redbird CV
Imperial, MO 63052-1748

Mailing address

5433 Redbird CV
Imperial, MO 63052-1748
Phone (314) 566-0251

Other providers in Imperial, MO

All providers in Imperial, MO · Occupational Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.