Charlotte A Liston, OTR/L
Individual provider Active NPI Occupational Therapist · Saint Clair, MO
NPI 1740443308 · NPPES record last updated Jul 3, 2008
Key facts
- NPI
- 1740443308
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 2004021748 (MO)
- Practice address
- 214 Hartman PL
Suite 200
Saint Clair, MO 63077-2464 - Phone
- (636) 629-9826
- Fax
- (636) 629-0359
- NPI assigned
- Jul 3, 2008
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2004021748 | MO | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2004021748 | MO | Yes |
Addresses
Primary practice location
214 Hartman PL
Suite 200
Saint Clair, MO 63077-2464
Mailing address
214 Hartman PL Unit 200
Saint Clair, MO 63077-2465
Phone (636) 629-9826
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2004021748 | Other | MO | OT LICENSE |
Other providers in Saint Clair, MO
- Haley Kelly
- Kiko Enterprises, LLC
- Kirk E. Brockman M.D. Dba St. Clair Medical Center
- Sheri Knight
- Susan Elizabeth Lindemann
- Living Well Home Care, LLC
- John D Marcum
- Taylor Alexis Martin
- Dennis J MC Coy
- Medley Pharmacy Inc
All providers in Saint Clair, MO · Occupational Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.