Provider Demographics
NPI:1366076697
Name:LAPOSHA, ISABELLE MARIE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:MARIE
Last Name:LAPOSHA
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 CASTLE PINES DR
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-4475
Mailing Address - Country:US
Mailing Address - Phone:314-852-4227
Mailing Address - Fax:
Practice Address - Street 1:14360 S OUTER 40 RD
Practice Address - Street 2:
Practice Address - City:TOWN AND COUNTRY
Practice Address - State:MO
Practice Address - Zip Code:63017-5710
Practice Address - Country:US
Practice Address - Phone:314-434-5410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020006299225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist