Doctor Name: | MR. GEORGE JOESEPH KNOECHEL |
NPI Number: | 1053325381 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 3165 Mckelvey Rd Suite 200 Bridgeton, MO - 630442550 |
Business Phone Number: | 3142063956 |
Business Fax Number: | 3142063992 |
Mailing Address: | 1430 Olive St, Suite 400 SAINT LOUIS |
State: | MO |
Postal Code: | 631032303 |
Phone Number: | 3142063956 |
Fax Number: | 3142063999 |
NPI Enumeration Date: | 07/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |