Amanda Slater, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Saint Clair, MO

NPI 1497563795 · NPPES record last updated Dec 19, 2024

Key facts

NPI
1497563795
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
2024045473 (MO)
Practice address
1773 W Springfield Rd
Saint Clair, MO 63077-4420
Phone
(636) 629-3571
NPI assigned
Dec 19, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2024045473MOMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2024045473 MO Yes

Addresses

Primary practice location

1773 W Springfield Rd
Saint Clair, MO 63077-4420

Mailing address

427 Caddy CT
Saint Clair, MO 63077-2466
Phone (314) 606-4138

Other providers in Saint Clair, MO

All providers in Saint Clair, MO · Occupational Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.