IndividualActive
Camille Fagan
NPI 1164084455 · Gerontology Occupational Therapist · Saint Louis, MO
Provider details
- NPI number
- 1164084455
- Entity type
- Individual
- Primary specialty
- Gerontology Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 2019017425 (MO)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
11960 Westline Industrial Dr Ste 201
Saint Louis, MO 63146-3209
Phone: (866) 433-9555
Approximate (ZIP-level) locationGet directions
Mailing address
27130 Hunt Dr
Wright City, MO 63390-4419
Registry dates
- Enumerated
- 2019-07-08
- Last updated
- 2024-10-01
- Certified
- 2024-10-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.