Healthcare Provider Details

I. General information

NPI: 1982194932
Provider Name (Legal Business Name): AIMEE LAYLA VARNADO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 FOREST PARK AVE STE 2600
SAINT LOUIS MO
63108-2212
US

IV. Provider business mailing address

660 S EUCLID AVE
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-286-1700
  • Fax: 314-747-6777
Mailing address:
  • Phone: 314-286-1700
  • Fax: 314-747-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA196661
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA196661
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number2026019713
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: