Mrs Tiarra Danielle Waller, OTR/L | |
21964 Highway 32, Ste Genevieve, MO 63670-9190 | |
(573) 883-9366 | |
(573) 883-9377 |
Full Name | Mrs Tiarra Danielle Waller |
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Gender | Female |
Speciality | Occupational Therapist |
Location | 21964 Highway 32, Ste Genevieve, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295472884 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 2021006924 (Missouri) | Primary |
Provider Name | Ste Genevieve County Memorial Hospital |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1184658387 PECOS PAC ID: 3274432802 Enrollment ID: O20040102000645 |
Provider Name | Mid America Rehab, P.c. |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1639143357 PECOS PAC ID: 9830236769 Enrollment ID: O20091027000269 |
Mailing Address | Practice Location Address |
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Mrs Tiarra Danielle Waller, OTR/L 21964 Highway 32, Ste Genevieve, MO 63670-9190 Ph: (573) 883-9366 | Mrs Tiarra Danielle Waller, OTR/L 21964 Highway 32, Ste Genevieve, MO 63670-9190 Ph: (573) 883-9366 |
Mrs. Mary Clare Rozier, OTR-L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 375 N 5th St, Ste Genevieve, MO 63670 Phone: 573-883-4500 Fax: 573-883-5957 | |
Courtney Lynn Bergman, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1100 Progress Pkwy, Ste Genevieve, MO 63670 Phone: 573-883-3454 |