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General NPI Number Information
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NPI Number | 1184471476
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Entity Type | Individual
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Provider Name | MICHAEL THOMAS MICHLER
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Gender | Male
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Dates
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Enumeration Date | 05/03/2024
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 1300 HAMPTON AVE STE 200
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City | SAINT LOUIS
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State | MO
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Zip | 63139-3163
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Country | US
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Telephone | 314-807-4181
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Fax |
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Provider Business Mailing Address
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Address Line | 2916 MIDDLEBUSH CT
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City | SAINT LOUIS
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State | MO
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Zip | 63119-1429
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Country | US
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Telephone | 314-807-4181
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2024029172
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License Number State | MO
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