Provider Demographics
NPI:1619085834
Name:HOWARD, BETH ANNE (PT)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANNE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANNE
Other - Last Name:BERNHARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:715 WILKINSON PL
Mailing Address - Street 2:
Mailing Address - City:LABADIE
Mailing Address - State:MO
Mailing Address - Zip Code:63055-1060
Mailing Address - Country:US
Mailing Address - Phone:314-579-6088
Mailing Address - Fax:
Practice Address - Street 1:901 PATIENTS FIRST DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-4700
Practice Address - Country:US
Practice Address - Phone:636-390-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO01619OtherLICENSE#