Healthcare Provider Details

I. General information

NPI: 1033221064
Provider Name (Legal Business Name): MEREDITH MELINDER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JEFFERSON BARRACKS DRIVE PSYCHOLOGY SERVICE (116A-JB)
SAINT LOUIS MO
63125
US

IV. Provider business mailing address

1 JEFFERSON BARRACKS DRIVE PSYCHOLOGY SERVICE (116A-JB)
SAINT LOUIS MO
63125
US

V. Phone/Fax

Practice location:
  • Phone: 314-894-4788
  • Fax:
Mailing address:
  • Phone: 314-652-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2005035954
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2005035954
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: