Healthcare Provider Details

I. General information

NPI: 1548176258
Provider Name (Legal Business Name): KARLI S RICHTER CTRS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3867 MAGNOLIA AVE
SAINT LOUIS MO
63110-4025
US

IV. Provider business mailing address

1105 RUTHERFORD RDG
O FALLON IL
62269-7012
US

V. Phone/Fax

Practice location:
  • Phone: 314-933-7330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number60696
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: