Doctor Name: | RICKEY DEON MINOR |
NPI Number: | 1164742862 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA, PLPC, ED, D |
License Number: | |
Business Practice Address: | 1430 Olive St Saint Louis, MO - 631032303 |
Business Phone Number: | 3146510921 |
Business Fax Number: | |
Mailing Address: | 1340 Partridge Ave, SAINT LOUIS |
State: | MO |
Postal Code: | 631301943 |
Phone Number: | 3148545737 |
Fax Number: | |
NPI Enumeration Date: | 06/03/2010 |
NPI Last Update Date: | 11/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |