| Doctor Name: | DEREK MCCLURE |
| NPI Number: | 1023401205 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 2012008595 |
| Business Practice Address: | 2120 Parkway Dr Saint Peters, MO - 633766459 |
| Business Phone Number: | 6362241158 |
| Business Fax Number: | 6369251443 |
| Mailing Address: | 2120 Parkway Dr, SAINT PETERS |
| State: | MO |
| Postal Code: | 633766459 |
| Phone Number: | 6362241158 |
| Fax Number: | 6369251443 |
| NPI Enumeration Date: | 03/11/2015 |
| NPI Last Update Date: | 03/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2012008595 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |