Provider Demographics
NPI:1003364340
Name:PITASSI, EMILY G (OT)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:G
Last Name:PITASSI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-286-1669
Mailing Address - Fax:314-514-3635
Practice Address - Street 1:14532 S OUTER 40 RD
Practice Address - Street 2:DEPT OCCUPATIONAL THERAPY, STE 120
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5705
Practice Address - Country:US
Practice Address - Phone:314-286-1669
Practice Address - Fax:314-514-3635
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008003137225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO470052736Medicaid