Provider Demographics
NPI:1174653489
Name:LEVY, DAVID (OT, CHT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:OT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6308 HAZELWEST CT
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-1739
Mailing Address - Country:US
Mailing Address - Phone:314-895-4664
Mailing Address - Fax:314-731-2340
Practice Address - Street 1:6308 HAZELWEST CT
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-1739
Practice Address - Country:US
Practice Address - Phone:314-895-4664
Practice Address - Fax:314-731-2340
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004580225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand