Healthcare Provider Details

I. General information

NPI: 1477457869
Provider Name (Legal Business Name): ANNA PETERS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 N NEW BALLAS RD STE 211
SAINT LOUIS MO
63141-6842
US

IV. Provider business mailing address

1015 HARVEST HOME CIR
SAINT CHARLES MO
63304-1617
US

V. Phone/Fax

Practice location:
  • Phone: 314-227-2124
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: