Provider Demographics
NPI:1386959393
Name:KUMMER, NATALI ANN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:NATALI
Middle Name:ANN
Last Name:KUMMER
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 1:1 VILLAGE SQUARE CTR
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-1817
Mailing Address - Country:US
Mailing Address - Phone:314-731-4555
Mailing Address - Fax:314-551-6110
Practice Address - Street 1:1 VILLAGE SQUARE CTR
Practice Address - Street 2:SUITE A
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-1817
Practice Address - Country:US
Practice Address - Phone:314-731-4555
Practice Address - Fax:314-551-6110
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO018969174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist