Healthcare Provider Details

I. General information

NPI: 1801679360
Provider Name (Legal Business Name): AUSTIN WESHINSKEY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AUSTIN GORDON

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 PARK AVE
SAINT LOUIS MO
63110-2514
US

IV. Provider business mailing address

3800 PARK AVE
SAINT LOUIS MO
63110-2514
US

V. Phone/Fax

Practice location:
  • Phone: 314-577-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: