Provider Demographics
NPI:1205155314
Name:PRESLEY, AMY KATHERINE (LMT, NCTMB)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:KATHERINE
Last Name:PRESLEY
Suffix:
Gender:F
Credentials:LMT, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 KINGSTON CT
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-6543
Mailing Address - Country:US
Mailing Address - Phone:314-721-7683
Mailing Address - Fax:
Practice Address - Street 1:8888 LADUE RD.
Practice Address - Street 2:STE. 260
Practice Address - City:LADUE
Practice Address - State:MO
Practice Address - Zip Code:63124-2056
Practice Address - Country:US
Practice Address - Phone:314-721-7688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO590103-10225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist