Healthcare Provider Details

I. General information

NPI: 1326504572
Provider Name (Legal Business Name): THERESA CATHERINE STRAKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2019
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 EUREKA TOWNE CENTER DR
EUREKA MO
63025-1031
US

IV. Provider business mailing address

647 SPIRIT AIRPARK WEST DR STE 101
CHESTERFIELD MO
63005-1032
US

V. Phone/Fax

Practice location:
  • Phone: 636-206-6725
  • Fax:
Mailing address:
  • Phone: 636-223-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: