Organization
SPARROW PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBIN SUSAN PARK MD (MANAGING MEMBER)
(314) 991-1033
Entity
Organization
Contact information
Practice address
777 CRAIG RD, SUITE 100, SAINT LOUIS, MO 63141-7138
(314) 991-1033
(314) 395-2432
Mailing address
777 CRAIG RD, SUITE 100, SAINT LOUIS, MO 63141-7138
(314) 991-1033
(314) 395-2432
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
LC0731335
MO
261QM0855X
Adolescent and Children Mental Health Clinic/Center
LC0731335
MO
Other
Enumeration date
10/26/2006
Last updated
01/17/2008
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