Rosemary Pates

Individual provider Active NPI Psychoanalyst · Saint Louis, MO

NPI 1568689727 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1568689727
Entity type
Individual (NPI type 1)
Primary specialty
Psychoanalyst 102L00000X
License
04101 (MO)
Practice address
1717 Biddle St
Murphy O'Fallon Health Clinic
Saint Louis, MO 63106-3454
Phone
(314) 814-8632
Fax
(314) 814-8542
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
04101MOMDPsychoanalyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X 04101 MO Yes

Addresses

Primary practice location

1717 Biddle St
Murphy O'Fallon Health Clinic
Saint Louis, MO 63106-3454

Mailing address

6418 Lake Paddock Dr
Florissant, MO 63033-4927
Phone (314) 775-9202

Other identifiers

IdentifierTypeStateIssuer
004101OtherMOLICENSED CLINICAL SW

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Psychoanalyst in Missouri

Sources for this page

Verify at the official NPI Registry.