Individual
CORRINE ANN DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1408 FARMVIEW AVE, SAINT LOUIS, MO 63138-2515
(314) 216-0199
(314) 741-8992
Mailing address
1408 FARMVIEW AVE, SAINT LOUIS, MO 63138-2515
(314) 216-0199
(314) 741-8992
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2002026438
MO
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
W236154637
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497178301
—
MO
Enumeration date
07/03/2007
Last updated
09/12/2021
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