Provider Demographics
NPI:1225885072
Name:LAMERS, KIRSTIN (OTR/L)
Entity type:Individual
Prefix:
First Name:KIRSTIN
Middle Name:
Last Name:LAMERS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 GARDEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63038-1491
Mailing Address - Country:US
Mailing Address - Phone:720-925-0904
Mailing Address - Fax:
Practice Address - Street 1:2 HARBOR BEND CT STE 102
Practice Address - Street 2:
Practice Address - City:LAKE ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-1480
Practice Address - Country:US
Practice Address - Phone:636-695-2075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024009457225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist