Healthcare Provider Details

I. General information

NPI: 1073092458
Provider Name (Legal Business Name): AMANDA S ZITTING MS, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11960 WESTLINE INDUSTRIAL DR STE 232
SAINT LOUIS MO
63146-3209
US

IV. Provider business mailing address

747 WESTWOOD DR APT 2N
CLAYTON MO
63105-2732
US

V. Phone/Fax

Practice location:
  • Phone: 314-421-8838
  • Fax:
Mailing address:
  • Phone: 417-955-1167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: