Provider Demographics
NPI:1669529822
Name:MEYER, MICHELE L
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:L
Last Name:MEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16551 VICTORIA CROSSING DR
Mailing Address - Street 2:UNIT F
Mailing Address - City:GROVER
Mailing Address - State:MO
Mailing Address - Zip Code:63040-1458
Mailing Address - Country:US
Mailing Address - Phone:636-405-1532
Mailing Address - Fax:
Practice Address - Street 1:7370 WELDON SPRINGS RD
Practice Address - Street 2:
Practice Address - City:DARDENNE PRAIRIE
Practice Address - State:MO
Practice Address - Zip Code:63368-8702
Practice Address - Country:US
Practice Address - Phone:636-851-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002118225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist