Provider Demographics
NPI:1023533312
Name:SEITRICH, JEANETTE M (MOTR/L)
Entity type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:M
Last Name:SEITRICH
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:JEANETTE
Other - Middle Name:MARIE
Other - Last Name:SCHWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:12110 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2516
Mailing Address - Country:US
Mailing Address - Phone:314-989-8100
Mailing Address - Fax:
Practice Address - Street 1:9801 EDGEFIELD DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-5418
Practice Address - Country:US
Practice Address - Phone:314-868-2454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016036932225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist