Provider Demographics
NPI:1780085035
Name:FAUST, ANNMARIE
Entity type:Individual
Prefix:MRS
First Name:ANNMARIE
Middle Name:
Last Name:FAUST
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ANNMARIE
Other - Middle Name:
Other - Last Name:NEUNUEBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:724 BROADRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-7509
Mailing Address - Country:US
Mailing Address - Phone:314-397-7198
Mailing Address - Fax:
Practice Address - Street 1:2300 SOUTHBEND DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-3719
Practice Address - Country:US
Practice Address - Phone:636-231-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014030963235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist