Provider Demographics
NPI:1881667962
Name:ENGEMANN, AMY AGASINO (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:AGASINO
Last Name:ENGEMANN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 RICHARD DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-6243
Mailing Address - Country:US
Mailing Address - Phone:314-920-9429
Mailing Address - Fax:
Practice Address - Street 1:138 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:MO
Practice Address - Zip Code:63080-1936
Practice Address - Country:US
Practice Address - Phone:573-468-5446
Practice Address - Fax:573-468-6387
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003001207225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics