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Individual

DR. RICHARD J. LAITMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
7700 BONHOMME AVE, SUITE 575, CLAYTON, MO 63105-1924
(314) 863-5111
(314) 721-7574
Mailing address
7700 BONHOMME AVE, SUITE 575, CLAYTON, MO 63105-1924
(314) 863-5111
(314) 721-7574

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
00287
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
498201805
MO
Enumeration date
03/14/2007
Last updated
08/28/2012
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