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General NPI Number Information
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NPI Number | 1346643277
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Entity Type | Organization
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Legal Business Name | PRESTON & ASSOCIATES PSYCHOLOGY FIRM, LLC
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 11/14/2014
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Provider Practice Location Address
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Address Line | 4144 LINDELL BLVD SUITE 317
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2927
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Country | US
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Telephone | 314-395-9437
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Fax |
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Provider Business Mailing Address
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Address Line | 4144 LINDELL BLVD SUITE 317
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2927
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Country | US
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Telephone | 314-395-9437
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARVA MONIQUE ROBINSON
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Credential | PSY.D
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Telephone | 314-395-9437
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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 | 2008032664
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License Number State | MO
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