Organization
DIVERSE VENTURES, LLC
Active
Organization
DIVERSE VENTURES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMECA FALCONER PHD (CLINICAL PSYCHOLOGIST/OWNER)
(314) 495-2600
Entity
Organization
Contact information
Practice address
69 BELLERIVE ACRES, SAINT LOUIS, MO 63121-4330
(314) 389-5007
(314) 389-6023
Mailing address
69 BELLERIVE ACRES, SAINT LOUIS, MO 63121-4330
(314) 389-5007
(314) 389-6023
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2006006565
MO
Other
Enumeration date
07/21/2006
Last updated
07/21/2022
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