Healthcare Provider Details

I. General information

NPI: 1104981463
Provider Name (Legal Business Name): FRANK H GILNER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 05/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 E MONROE AVE
KIRKWOOD MO
63122-6320
US

IV. Provider business mailing address

622 E MONROE AVE
KIRKWOOD MO
63122-6320
US

V. Phone/Fax

Practice location:
  • Phone: 314-966-5631
  • Fax: 314-835-1172
Mailing address:
  • Phone: 314-966-5631
  • Fax: 314-835-1172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number42
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number42
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number42
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: