Basic Information
| Provider Information | |||||||||
| NPI: | 1952360463 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESTILL | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | FAY | ||||||||
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| Credential: | MA CCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1008 S SPRING AVE # 3300 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631102520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149778884 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 555 N NEW BALLAS RD STE 260 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631416886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149776362 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2006 | ||||||||
| LastUpdateDate: | 02/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | 001114 | MO | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 231H00000X | 104570 | MO | N | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.