Individual
JULIE E. LAFFERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12277 DE PAUL DR, SUITE 303 SOUTH, BRIDGETON, MO 63044-2516
(314) 344-7575
(314) 344-7571
Mailing address
11477 OLDE CABIN RD STE 200, ST LOUIS, MO 63141-7137
(314) 567-5000
(314) 567-3110
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
108402
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120928
BLUE CROSS BLUE SHIELD
MO
01
—
1533327
UNITED HEALTHCARE
MO
01
—
260040209
RR MEDICARE
MO
Enumeration date
08/30/2006
Last updated
09/15/2015
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