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Individual

DR. SUSAN REIS BUTLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DOCTORATE

Contact information

Practice address
12962 TESSON FERRY RD, SAINT LOUIS, MO 63128-2915
(314) 849-7177
Mailing address
7654 RIVER WALK CT, SAINT LOUIS, MO 63129-5830
(314) 846-9616
(314) 846-3531

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PYO 1451
MO
103TC1900X
Counseling Psychologist
PYO 1451
MO
103TF0000X
Family Psychologist
PYO 1451
MO
103TP2701X
Group Psychotherapy Psychologist
PYO 1451
MO
103TP2701X
Group Psychotherapy Psychologist
PYO1451
MO

Other

Enumeration date
05/03/2006
Last updated
09/11/2019
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