Doctor Name: | DR. MARYBETH PEREIRA |
NPI Number: | 1053407270 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | R9667 |
Business Practice Address: | 1 Jefferson Barracks Drjefferson Barracks Va Medical Center St Louis, MO - 631254199 |
Business Phone Number: | 3148946677 |
Business Fax Number: | 3148455039 |
Mailing Address: | 12824 Topping Acres, SAINT LOUIS |
State: | MO |
Postal Code: | 631311436 |
Phone Number: | 3149651208 |
Fax Number: | |
NPI Enumeration Date: | 10/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225400000X |
License Number: | R9667 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Rehabilitation Practitioner |
Taxonomy Specialization: | |
Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |