Kathryn Lee Corley Llc | |
10420 Old Olive St. Rd. Suite 202 St. Louis MO 63141 | |
(314) 991-9700 | |
(314) 991-7779 |
Full Name | Kathryn Lee Corley Llc |
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Speciality | Social Worker |
Location | 10420 Old Olive St. Rd., St. Louis, Missouri |
Authorized Official Name and Position | Kathryn Lee Corley (LLC) |
Authorized Official Contact | 3149919700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kathryn Lee Corley Llc 10420 Old Olive St. Rd. Suite 202 St. Louis MO 63141 Ph: (314) 991-9700 | Kathryn Lee Corley Llc 10420 Old Olive St. Rd. Suite 202 St. Louis MO 63141 Ph: (314) 991-9700 |
NPI Number | 1982929550 |
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Provider Enumeration Date | 04/07/2010 |
Last Update Date | 07/22/2010 |
Medicare PECOS PAC ID | 1951433622 |
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Medicare Enrollment ID | O20100715000285 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982929550 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 002714 (Missouri) | Primary |
Provider Name | Kathryn L Corley |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1568586634 PECOS PAC ID: 9739288762 Enrollment ID: I20070615000419 |
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