Michele Merrell Bryan, PH.D.

Individual provider Active NPI Marriage & Family Therapist · Saint Louis, MO

NPI 1487861399 · NPPES record last updated Sep 13, 2012

Key facts

NPI
1487861399
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
2003017952 (MO)
Practice address
24 Dromara Rd
Saint Louis, MO 63124-1815
Phone
(314) 993-8964
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2003017952MOMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2003017952 MO Yes

Addresses

Primary practice location

24 Dromara Rd
Saint Louis, MO 63124-1815

Mailing address

983 Gardenview Office Pkwy
Saint Louis, MO 63141-5917
Phone (314) 910-0404

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Marriage & Family Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.