Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2012037884 | MO |
NPI | 1003309824 |
---|---|
Provider Name | Hilde Anne Maagad |
First Address | Saint Louis, MO 63112-3104 |
Second Address | Saint Louis, MO 63112-3104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2018 |
Last Update Date | 07/06/2018 |