Individual
DR. KENTON LEE WERTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
130 S BEMISTON AVE, STE. 506, CLAYTON, MO 63105-1913
(314) 863-6161
(314) 863-6695
Mailing address
130 S BEMISTON AVE, STE. 506, CLAYTON, MO 63105-1913
(314) 863-6161
(314) 863-6695
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01403
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000070720
PTAN
MO
Enumeration date
11/28/2006
Last updated
01/16/2013
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