Organization
VETERANS AFFAIRS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINTERS (BUSINESS MANAGER)
(314) 289-7676
Entity
Organization
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2006031019
MO
Other
Enumeration date
10/11/2006
Last updated
10/15/2008
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