Healthcare Provider Details

I. General information

NPI: 1477930394
Provider Name (Legal Business Name): LOUIS APPELMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4066 DUNNICA AVE
SAINT LOUIS MO
63116-3510
US

IV. Provider business mailing address

4066 DUNNICA AVE
SAINT LOUIS MO
63116-3510
US

V. Phone/Fax

Practice location:
  • Phone: 636-224-1757
  • Fax: 314-535-5917
Mailing address:
  • Phone: 636-224-1757
  • Fax: 314-535-5917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2012039994
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: