Provider Demographics
NPI:1962539023
Name:SIEMER, DIANE ILENE (OTR)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:ILENE
Last Name:SIEMER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11829 VILLA DORADO DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4701
Mailing Address - Country:US
Mailing Address - Phone:314-432-4456
Mailing Address - Fax:
Practice Address - Street 1:1170 TIMBER RUN DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4482
Practice Address - Country:US
Practice Address - Phone:314-469-0606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics