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NPI Code Detail

MEDICARE: AMANDA JEAN STRUCKMEYER

MEDICARE: AMANDA JEAN STRUCKMEYER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2011032948MO

General Provider Information

NPI Number : 1679838205
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JEAN STRUCKMEYER
Provider Business Mailing Address
First Line : 12380 DE PAUL DR
Second Line : SSM DAY INSTITUTE
City : BRIDGETON
State : MO
Zip : 63044-2511
Country : US
Telephone Number : 314-447-9710
Fax Number :
Provider Business Practice Location Address
First Line : 12380 DE PAUL DR
Second Line : SSM DAY INSTITUTE
City : BRIDGETON
State : MO
Zip : 63044-2511
Country : US
Telephone Number : 314-447-9710
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2012
Last Update Date : 01/24/2017

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Directions to “ AMANDA JEAN STRUCKMEYER ” Practice Location

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