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General NPI Number Information
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NPI Number | 1225760309
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Entity Type | Organization
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Legal Business Name | ZECARICH INCORPORATED
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 844 N NEW BALLAS CT
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City | CREVE COEUR
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State | MO
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Zip | 63141-7174
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Country | US
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Telephone | 314-482-5223
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Fax |
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Provider Business Mailing Address
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Address Line | 844 N NEW BALLAS CT
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City | CREVE COEUR
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State | MO
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Zip | 63141-7174
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Country | US
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Telephone | 314-482-5223
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | PAMELA LATARSHA BUCHANAN
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Credential |
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Telephone | 636-866-2308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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