Doctor Name: | MRS. STACEY NENTWIG GREER |
NPI Number: | 1184773285 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. |
License Number: | 002563 |
Business Practice Address: | 425 N New Ballas Rd Suite 195 Creve Coeur, MO - 631416814 |
Business Phone Number: | 3149991566 |
Business Fax Number: | 3149910666 |
Mailing Address: | 425 N New Ballas Rd, Suite 195 CREVE COEUR |
State: | MO |
Postal Code: | 631416814 |
Phone Number: | 3149991566 |
Fax Number: | 3149910666 |
NPI Enumeration Date: | 01/09/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 002563 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |