Healthcare Provider Details
I. General information
NPI: 1306865944
Provider Name (Legal Business Name): SANDRA K FILER M.A.,L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10425 OLD OLIVE STREET RD SUITE209
CREVE COEUR MO
63141-5940
US
IV. Provider business mailing address
10425 OLD OLIVE STREET RD SUITE209
CREVE COEUR MO
63141-5940
US
V. Phone/Fax
- Phone: 314-995-9578
- Fax: 636-458-5119
- Phone: 314-995-9578
- Fax: 636-458-5119
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 003206 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: