Organization
RAYMOND T FEZZI, LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND T FEZZI LCSW (PSYCHOTHERAPIST)
(314) 894-9696
Entity
Organization
Contact information
Practice address
6220 S LINDBERGH BLVD, SUITE 201, SAINT LOUIS, MO 63123-7839
(314) 894-9696
(314) 894-2942
Mailing address
6220 S LINDBERGH BLVD, SUITE 201, SAINT LOUIS, MO 63123-7839
(314) 894-9696
(314) 894-2942
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000775
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
753263201
—
MO
Enumeration date
07/11/2016
Last updated
07/11/2016
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