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Organization

ST CHARLES WEST PSYCHOLOGICAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VALERIE ANDRADE (ACCT MANAGER)
(314) 432-2580
Entity
Organization

Contact information

Practice address
600 MEDICAL DR STE 205, WENTZVILLE, MO 63385-3426
(314) 432-2580
(314) 432-0223
Mailing address
600 MEDICAL DR STE 205, WENTZVILLE, MO 63385-3426
(314) 432-2580
(314) 432-0223

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
10/25/2006
Last updated
08/31/2009
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