Healthcare Provider Details

I. General information

NPI: 1912468356
Provider Name (Legal Business Name): HANNAH MICHELLE PLATIPODIS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH MICHELLE WILLIAMS BS

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 01/25/2022
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 CALIFORNIA AVE
SAINT LOUIS MO
63104-2046
US

IV. Provider business mailing address

508 NIGHTINGALE LN
SAINT LOUIS MO
63123-7610
US

V. Phone/Fax

Practice location:
  • Phone: 314-771-2539
  • Fax:
Mailing address:
  • Phone: 314-315-2660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number12147627
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: