Individual
MICHAEL KOLESSAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
12380 DE PAUL DR, BRIDGETON, MO 63044-2511
(314) 447-9705
Mailing address
12380 DE PAUL DR, BRIDGETON, MO 63044-2511
(314) 447-9705
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Enumeration date
12/18/2009
Last updated
10/03/2013
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