Provider Demographics
NPI:1235466533
Name:MUIR, SHERRY LYNNE (MOT, OTR)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:LYNNE
Last Name:MUIR
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3437 CAROLINE ST
Mailing Address - Street 2:ROOM 2020
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1111
Mailing Address - Country:US
Mailing Address - Phone:314-977-8581
Mailing Address - Fax:314-977-5414
Practice Address - Street 1:3691 RUTGER ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2515
Practice Address - Country:US
Practice Address - Phone:314-977-6828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001014225X00000X
IL056.002760225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist