Healthcare Provider Details

I. General information

NPI: 1770509960
Provider Name (Legal Business Name): MICHELLE M SALOIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 MANCHESTER RD
MAPLEWOOD MO
63143-2403
US

IV. Provider business mailing address

2609 ABBOTT PL
SAINT LOUIS MO
63143-2609
US

V. Phone/Fax

Practice location:
  • Phone: 314-993-8818
  • Fax:
Mailing address:
  • Phone: 314-993-8818
  • Fax: 314-983-0331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number140-010352
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number002117
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: