Healthcare Provider Details

I. General information

NPI: 1275451312
Provider Name (Legal Business Name): AMARRIA JANELL MUMPHARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 GREENWOOD AVE
WEST PALM BEACH FL
33407-2442
US

IV. Provider business mailing address

1312 NORTHERN DANCER CT
FLORISSANT MO
63034-3308
US

V. Phone/Fax

Practice location:
  • Phone: 561-842-7588
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2026026025
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: