Individual
MR. ANTHONY DALE UDZIELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
13354 MANCHESTER RD, STE 220, SAINT LOUIS, MO 63131-1709
(314) 614-9730
(314) 692-7929
Mailing address
13354 MANCHESTER RD, STE 220, SAINT LOUIS, MO 63131-1709
(314) 614-9730
(314) 692-7929
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY01064
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00007511UDZ
MERCY HEALTH PLAN
—
01
—
061234
EXCLUSIVE CHOICE
—
01
—
118890
HEALTHLINK
—
01
—
132604
CMR
—
01
—
26999
BLUE CROSS BLUE SHIELD OF
MO
01
—
6153019
UNITED HEALTHCARE UNITED
—
01
—
A805509
VALUEOPTIONS
—
Enumeration date
09/26/2006
Last updated
07/08/2007
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