Provider First Line Business Practice Location Address:
1 UNIVERSITY BLVD., COMMUNITY PSYCHOLOGICAL SERVICE
Provider Second Line Business Practice Location Address:
UNIVERSITY OF MISSOURI-ST. LOUIS
Provider Business Practice Location Address City Name:
ST. LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-516-5824
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/19/2007