Provider Demographics
NPI:1598838732
Name:WOKURKA, CARA NICOLE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CARA
Middle Name:NICOLE
Last Name:WOKURKA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:CARA
Other - Middle Name:NICOLE
Other - Last Name:BREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:403 HARBY DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-4622
Mailing Address - Country:US
Mailing Address - Phone:314-280-7655
Mailing Address - Fax:
Practice Address - Street 1:13995 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:TOWN AND COUNTRY
Practice Address - State:MO
Practice Address - Zip Code:63017-8400
Practice Address - Country:US
Practice Address - Phone:636-227-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005020587225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist