Individual
DR. ALICE G VLIETSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
745 CRAIG RD STE 102C, SAINT LOUIS, MO 63141-7122
(314) 729-2855
(314) 529-3534
Mailing address
3042 ANDOVER DR, SAINT LOUIS, MO 63121-4606
(314) 882-5537
(314) 529-3534
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
01089
MO
106H00000X
Marriage & Family Therapist
300075
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075243
VALUE OPTIONS
MO
01
—
1601
BLUE CROSS BLUE SHIELD
MO
Enumeration date
03/15/2007
Last updated
10/27/2025
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