Individual
MRS. NICOLE CASSIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1 BROOKINGS DR, SAINT LOUIS, MO 63130-4862
(314) 935-6666
(314) 935-8515
Mailing address
1201 RICKER RD, PO BOX 1250, SALEM, IL 62881-4263
(314) 935-6666
(314) 935-8515
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2015032100
MO
Other
Enumeration date
09/01/2010
Last updated
11/02/2015
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