Provider Demographics
NPI:1073867461
Name:PREISS, TAMETTE MICHELE (OTR)
Entity Type:Individual
Prefix:
First Name:TAMETTE
Middle Name:MICHELE
Last Name:PREISS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 JACQUELINE KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-5067
Mailing Address - Country:US
Mailing Address - Phone:314-330-8440
Mailing Address - Fax:
Practice Address - Street 1:12 JACQUELINE KNOLL CT
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-5067
Practice Address - Country:US
Practice Address - Phone:314-330-8440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006038275225X00000X
IL056010200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist