Doctor Name: | BETH ANN DAMKE |
NPI Number: | 1255647772 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | COTA/L |
License Number: | 2009014390 |
Business Practice Address: | 1 Village Square Ctr Ste A Hazelwood, MO - 630421817 |
Business Phone Number: | 3147314555 |
Business Fax Number: | 3145576110 |
Mailing Address: | 942 Scotch Pine Trl, FORISTELL |
State: | MO |
Postal Code: | 633481522 |
Phone Number: | 3145660282 |
Fax Number: | |
NPI Enumeration Date: | 08/21/2010 |
NPI Last Update Date: | 08/21/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 2009014390 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |