Individual
DOROTHY LANE BROOKE FAHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1129 MACKLIND AVE, SAINT LOUIS, MO 63110-1440
(314) 534-0200
Mailing address
1129 MACKLIND AVE, SAINT LOUIS, MO 63110-1440
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2021035556
MO
Other
Enumeration date
11/03/2021
Last updated
11/07/2022
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