Basic Information
| Provider Information | |||||||||
| NPI: | 1235466533 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUIR | ||||||||
| FirstName: | SHERRY | ||||||||
| MiddleName: | LYNNE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MOT, OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3437 CAROLINE ST | ||||||||
| Address2: | ROOM 2020 | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631041111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149778581 | ||||||||
| FaxNumber: | 3149775414 | ||||||||
| Practice Location | |||||||||
| Address1: | 3691 RUTGER ST | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631102515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149776828 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2009 | ||||||||
| LastUpdateDate: | 11/06/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 001014 | MO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | 056.002760 | IL | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.