NPI 1073182309

Madison Baniak

Practitioner Occupational Therapy Assistant Saint Peters, MO

Practice location

Address: 1408 Granite Ridge Dr, Saint Peters, MO 63303-1621
Phone: (314) 306-1359

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence 2021007633 (MO)

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Registry record

NPI: 1073182309
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Jun 2021
Record last updated: 21 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.