Provider Demographics
NPI:1922556109
Name:MCQUEEN, KATHRYN SUE (OT)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:SUE
Last Name:MCQUEEN
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Gender:F
Credentials:OT
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Mailing Address - Street 1:4444 FOREST PARK AVE
Mailing Address - Street 2:C B 8505
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2212
Mailing Address - Country:US
Mailing Address - Phone:314-286-1669
Mailing Address - Fax:314-286-1601
Practice Address - Street 1:14532 SOUTH OUTER 40 RD STE 120
Practice Address - Street 2:STE 120
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5784
Practice Address - Country:US
Practice Address - Phone:314-362-7398
Practice Address - Fax:314-514-3635
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2023-03-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2012001637225X00000X
MI5201011180225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist