Healthcare Provider Details

I. General information

NPI: 1417354374
Provider Name (Legal Business Name): MS. BRITTANY MARIE JOSEPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2014
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12855 N 40 DR 250
SAINT LOUIS MO
63141-8657
US

IV. Provider business mailing address

12855 N 40 DR 250
SAINT LOUIS MO
63141-8657
US

V. Phone/Fax

Practice location:
  • Phone: 314-469-0760
  • Fax: 314-469-0034
Mailing address:
  • Phone: 314-469-0760
  • Fax: 314-469-0034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number2014040523
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: