Basic Information
| Provider Information | |||||||||
| NPI: | 1619132610 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUENZEL | ||||||||
| FirstName: | RENEE | ||||||||
| MiddleName: | ANNETTE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | OTR/L | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LAFOND | ||||||||
| OtherFirstName: | RENEE | ||||||||
| OtherMiddleName: | ANNETTE | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4455 KOHL CITY RD | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630682335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149744021 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7733 FORSYTH BLVD | ||||||||
| Address2: | |||||||||
| City: | CLAYTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631051817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8006771238 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2008 | ||||||||
| LastUpdateDate: | 03/27/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 001849 | MO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.