| Mrs Tiarra Danielle Waller, OTR/L | |
|
21964 Highway 32, Ste Genevieve, MO 63670-9190 | |
| (573) 883-9366 | |
| (573) 883-9377 |
| Full Name | Mrs Tiarra Danielle Waller |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 21964 Highway 32, Ste Genevieve, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295472884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 2021006924 (Missouri) | Primary |
| Provider Name | Ste Genevieve County Memorial Hospital |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1184658387 PECOS PAC ID: 3274432802 Enrollment ID: O20040102000645 |
| Provider Name | Mid America Rehab, P.c. |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1639143357 PECOS PAC ID: 9830236769 Enrollment ID: O20091027000269 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Tiarra Danielle Waller, OTR/L 21964 Highway 32, Ste Genevieve, MO 63670-9190 Ph: (573) 883-9366 | Mrs Tiarra Danielle Waller, OTR/L 21964 Highway 32, Ste Genevieve, MO 63670-9190 Ph: (573) 883-9366 |
Mrs. Mary Clare Rozier, OTR-L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 375 N 5th St, Ste Genevieve, MO 63670 Phone: 573-883-4500 Fax: 573-883-5957 | |
Courtney Lynn Bergman, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1100 Progress Pkwy, Ste Genevieve, MO 63670 Phone: 573-883-3454 |