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Individual

AMANDA THERESA VAICIKAUSKAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12349 DEPAUL DRIVE, SUITE 110, BRIDGETON, MO 63044
(314) 209-7700
Mailing address
12349 DEPAUL DRIVE, SUITE 110, BRIDGETON, MO 63044
(314) 209-7700

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0000006593
TN
225X00000X
Occupational Therapist
Primary
2020006487
MO

Other

Enumeration date
03/20/2020
Last updated
08/09/2024
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