Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 2008003137 | MO |
N | 225XH1200X | Occupational Therapist - Hand | 2008003137 | MO |
NPI | 1003364340 |
---|---|
Provider Name | Ms. Emily G Pitassi |
First Address | Saint Louis, MO 63108-2212 |
Second Address | Chesterfield, MO 63017-5705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2016 |
Last Update Date | 15/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
470052736 | (05) | MO |