MEDICARE: MRS. HANNAH MICHELLE PLATIPODIS MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	12147627	MO

General Provider Information

NPI Number	:	1912468356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HANNAH MICHELLE PLATIPODIS MS

Provider Business Mailing Address
First Line	:	508 NIGHTINGALE LN
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-7610
Country	:	US
Telephone Number	:	314-315-2660
Fax Number	:

Provider Business Practice Location Address
First Line	:	1616 CALIFORNIA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-2046
Country	:	US
Telephone Number	:	314-771-2539
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2019
Last Update Date	:	01/25/2022

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