Healthcare Provider Details

I. General information

NPI: 1538076328
Provider Name (Legal Business Name): AMY FREY OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 HARVEST RIDGE DR
SAINT CHARLES MO
63303-5972
US

IV. Provider business mailing address

27 GARY GLEN DR
SAINT PETERS MO
63376-1915
US

V. Phone/Fax

Practice location:
  • Phone: 636-851-5162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2025003002
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: