Individual
GERARDA THERESA WEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10000 WATSON RD # 2L18, PERSONAL POTENTIALS INC, SAINT LOUIS, MO 63126-1854
(314) 822-4727
(314) 822-0531
Mailing address
10000 WATSON RD # 2L18, PERSONAL POTENTIALS INC, SAINT LOUIS, MO 63126-1854
(314) 822-4727
(314) 822-0531
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
001280
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011869
A/B NETWORK PROVIDER
—
01
—
100879
BCBS NETWORK PROVIDER
—
01
—
27033
COMPSYCH NETWORK PROVIDER
—
Enumeration date
08/29/2006
Last updated
10/07/2008
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