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General NPI Number Information
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NPI Number | 1174343107
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Entity Type | Organization
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Legal Business Name | TSE PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 7110 OAKLAND AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1868
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Country | US
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Telephone | 314-270-2343
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 430175
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City | SAINT LOUIS
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State | MO
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Zip | 63143-0275
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Country | US
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Telephone | 314-270-2343
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST/OWNER
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Name | DR. TIMIKA SHERELL EDWARDS
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Credential | PHD
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Telephone | 314-270-2343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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