Provider Demographics
NPI:1346087475
Name:GOLDEN, EMILY MARIE (COTA/L)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:GOLDEN
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 1:2085 BLUESTONE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-6727
Mailing Address - Country:US
Mailing Address - Phone:314-688-5226
Mailing Address - Fax:314-451-8501
Practice Address - Street 1:2085 BLUESTONE DR STE 202
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-6727
Practice Address - Country:US
Practice Address - Phone:636-896-0999
Practice Address - Fax:636-896-0998
Is Sole Proprietor?:No
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023039892224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant