Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Madison Baniak

Individual provider Occupational Therapy Assistant · NPI 1073182309

Madison Baniak is an Occupational Therapy Assistant in Saint Peters, Missouri. Practices as a sole proprietor and works from 2 locations. Licensed in Missouri.

Licensed in
MO
In the registry since
2021

Practice location Address checks out

1408 Granite Ridge Dr
Saint Peters, MO 63303-1621
Phone: (314) 306-1359
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 456 N New Ballas Rd, Saint Louis, MO 63141-6831 — (201) 421-8229

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 2021007633 (MO)

Record details

NPI number1073182309
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 21, 2021
Last updated in NPPESJune 21, 2021
Certification dateJune 21, 2021
Mailing address1408 Granite Ridge Dr, Saint Peters, MO 63303-1621

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