Individual
MS. AMANDA MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
4444 FOREST PARK AVE, DEPT OCCUPATIONAL THERAPY, STE 2210, SAINT LOUIS, MO 63108-2212
(314) 286-1669
(314) 627-7219
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 286-1669
(314) 627-7219
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2022040864
MO
Other
Enumeration date
11/02/2023
Last updated
04/17/2025
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