Healthcare Provider Details

I. General information

NPI: 1093574394
Provider Name (Legal Business Name): CATHERINE OLEARY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 06/28/2025
Certification Date: 06/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 SCARLET BEND CT
SAINT LOUIS MO
63122-6950
US

IV. Provider business mailing address

1005 SCARLET BEND CT
SAINT LOUIS MO
63122-6950
US

V. Phone/Fax

Practice location:
  • Phone: 314-498-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number2025025945
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: