Individual
DR. THERESA M VAN ISEGHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2727 WASHINGTON AVE, SAINT LOUIS, MO 63103-1421
(314) 534-8778
Mailing address
334 POINTE LOMA BLVD, LAKE ST LOUIS, MO 63367-4301
(314) 591-0093
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007872
IL
Other
Enumeration date
03/24/2010
Last updated
04/25/2024
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