| St. Louis Eating Recovery Therapy, Llc | |
|
140 Prospect Ave Ste L Kirkwood MO 63122-6024 | |
| (314) 896-0810 | |
| Not Available |
| Full Name | St. Louis Eating Recovery Therapy, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 140 Prospect Ave Ste L, Kirkwood, Missouri |
| Authorized Official Name and Position | Nicole Jacobs (OWNER/THERAPIST) |
| Authorized Official Contact | 3146091874 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Louis Eating Recovery Therapy, Llc 637 S Pam Ave Saint Charles MO 63301-4866 Ph: () - | St. Louis Eating Recovery Therapy, Llc 140 Prospect Ave Ste L Kirkwood MO 63122-6024 Ph: (314) 896-0810 |
| NPI Number | 1528640075 |
|---|---|
| Provider Enumeration Date | 04/24/2021 |
| Last Update Date | 04/24/2021 |
| Certification Date | 04/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528640075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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