Provider Demographics
NPI:1942962527
Name:PIGG, MICHELLE (COTA/L)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:PIGG
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6476 CEDAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:MO
Mailing Address - Zip Code:63016-2419
Mailing Address - Country:US
Mailing Address - Phone:314-686-3873
Mailing Address - Fax:
Practice Address - Street 1:6400 THE CEDARS CT
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:MO
Practice Address - Zip Code:63016-2220
Practice Address - Country:US
Practice Address - Phone:636-274-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018014582224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant