Individual
THETA P GRIBBINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
60 HILL POINTE CT STE 206, SAINT CHARLES, MO 63303-4099
(636) 493-9912
(636) 493-9913
Mailing address
60 HILL POINTE CT STE 206, SAINT CHARLES, MO 63303-4099
(636) 493-9912
(636) 493-9913
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2011032755
MO
103TC0700X
Clinical Psychologist
Primary
2011037832
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232812942
SAINT LOUIS BEHAVIORAL MEDICINE INSTITUTE
MO
01
—
46-0760135
ST CHARLES PSYCH TESTING & THERAPY
MO
Enumeration date
10/28/2011
Last updated
10/08/2012
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