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NPI Code Detail

MEDICARE: ABIGAIL DEANNA

MEDICARE: ABIGAIL DEANNA
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
1225X00000XOccupational Therapist2025027137MO

General Provider Information

NPI Number : 1851280788
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL DEANNA
Provider Business Mailing Address
First Line : 4300 MARYLAND AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63108-2704
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5 DOCUMENT DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63114-6100
Country : US
Telephone Number : 314-970-9115
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2025
Last Update Date : 07/03/2025

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Directions to “ ABIGAIL DEANNA ” Practice Location

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