Provider Demographics
NPI:1093577975
Name:BUSY FEET
Entity Type:Organization
Organization Name:BUSY FEET
Other - Org Name:BUSY FEET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:INEZ
Authorized Official - Last Name:VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:314-518-8991
Mailing Address - Street 1:87 EDWARD DR STE B
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MO
Mailing Address - Zip Code:63025-1123
Mailing Address - Country:US
Mailing Address - Phone:314-518-8991
Mailing Address - Fax:
Practice Address - Street 1:87 EDWARD DR # B
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MO
Practice Address - Zip Code:63025-1123
Practice Address - Country:US
Practice Address - Phone:314-518-8991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency