Individual
DR. DANIEL JEREMY WILLIGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10820 SUNSET OFFICE DR 210, SAINT LOUIS, MO 63127-1030
(314) 712-0365
(314) 549-8807
Mailing address
10820 SUNSET OFFICE DR 210, SAINT LOUIS, MO 63127-1030
(314) 712-0365
(314) 549-8807
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
01435
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
493524300
—
MO
01
—
MA2526
MEDICARE PTAN
MO
Enumeration date
09/12/2006
Last updated
11/30/2015
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