Individual
DR. MICHELE LEE PERGADIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4901 FOREST PARK AVE, DEPT PSYCHIATRY, STE 441, SAINT LOUIS, MO 63108-1495
(314) 286-1700
(314) 970-9094
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 286-1700
(314) 970-9094
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
2006016151
MO
103T00000X
Psychologist
Primary
2006016151
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497158907
—
MO
Enumeration date
10/29/2009
Last updated
04/17/2025
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