Healthcare Provider Details

I. General information

NPI: 1679808224
Provider Name (Legal Business Name): LOUIS FAGGETTI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9378 OLIVE BLVD SUITE 106
SAINT LOUIS MO
63132-3215
US

IV. Provider business mailing address

9378 OLIVE BLVD SUITE 106
SAINT LOUIS MO
63132-3215
US

V. Phone/Fax

Practice location:
  • Phone: 314-809-8226
  • Fax: 314-567-8581
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: