Provider Demographics
NPI:1003935990
Name:SHAPIRO, THERESE M (OT)
Entity type:Individual
Prefix:
First Name:THERESE
Middle Name:M
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 S CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-4629
Mailing Address - Country:US
Mailing Address - Phone:314-447-8511
Mailing Address - Fax:314-447-8747
Practice Address - Street 1:524 S CRESCENT DR
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-4629
Practice Address - Country:US
Practice Address - Phone:314-447-8511
Practice Address - Fax:314-447-8747
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-007774225X00000X
MO2006011143225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist