Individual
MARY ELIZABETH WEATHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5667
(314) 268-2784
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5667
(314) 268-2784
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
R0308
MO
Other
Enumeration date
05/10/2007
Last updated
11/09/2020
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