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Dr. Amy Kathleen Licis, MD
Neurology Physician in Saint Louis, Missouri
NPI 1992914352

Amy Kathleen Licis is a Neurology Physician based in Saint Louis, MO and is specialized in Neurology. Amy Kathleen Licis practices in Saint Louis, MO and has the professional credentials of MD. The NPI Number for Amy Kathleen Licis is 1992914352 and holds a License No. 2009014878 (Missouri).

The current practice location address for Amy Kathleen Licis is 1600 S Brentwood Blvd, Saint Louis, MO and can be reached out via phone at 314-362-1408 and via fax at 314-747-4342.

Location: 1600 S Brentwood Blvd, Saint Louis, MO, 63160-0352
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992914352
Provider Name
Amy Kathleen Licis
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
1600 S Brentwood Blvd, Saint Louis, MO, 63160-0352
Phone Number
314-362-1408
Fax Number
314-747-4342
Provider Enumeration Date
05/22/2007
Last Update Date
05/18/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
204515803 05 MO
institution
Provider Business Practice Location Address Details
Address
1600 S Brentwood Blvd
City
Saint Louis
State
Missouri
Zip
63144-1320
Phone Number
314-362-1408
Fax Number
314-747-4342
person
Provider Business Mailing Address Details
Address
1600 S Brentwood Blvd
City
Saint Louis
State
Missouri
Zip
63144-1320
Phone Number
314-362-1408
Fax Number
314-747-4342
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Pediatrics
Speciality
Sleep Medicine
Taxonomy
2080S0012X
License No.
2009014878 (Missouri)
Definition
A Pediatrician who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Neurology
Taxonomy
2084N0400X
License No.
2009014878 (Missouri)
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
person
Provider's Taxonomy Details 3
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Neurology with Special Qualifications in Child Neurology
Taxonomy
2084N0402X
License No.
2009014878 (Missouri)
Definition
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
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