Healthcare Provider Details

I. General information

NPI: 1861524480
Provider Name (Legal Business Name): KATHERINE DREWRY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNIVERSITY BLVD KATHY J. WEINMAN CENTER
SAINT LOUIS MO
63121-4400
US

IV. Provider business mailing address

1155 CLAYTONIA TER APT. 2-SOUTH
SAINT LOUIS MO
63117-1572
US

V. Phone/Fax

Practice location:
  • Phone: 314-516-7364
  • Fax: 314-516-6624
Mailing address:
  • Phone: 314-516-7364
  • Fax: 314-516-6624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2005002664
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: