| Institute Of Intrapersonal Development, Llc | |
|
1872 Woodhollow Drive Apt. 211 Maryland Heights MO 63043-3957 | |
| (314) 625-6070 | |
| Not Available |
| Full Name | Institute Of Intrapersonal Development, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1872 Woodhollow Drive, Maryland Heights, Missouri |
| Authorized Official Name and Position | Jerisha Lacrae Rutlin (FOUNDER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 3146256070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Institute Of Intrapersonal Development, Llc 1872 Woodhollow Drive Apt. 211 Maryland Heights MO 63043-3957 Ph: (314) 625-6070 | Institute Of Intrapersonal Development, Llc 1872 Woodhollow Drive Apt. 211 Maryland Heights MO 63043-3957 Ph: (314) 625-6070 |
| NPI Number | 1700484599 |
|---|---|
| Provider Enumeration Date | 10/13/2020 |
| Last Update Date | 10/13/2020 |
| Certification Date | 10/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700484599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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