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General NPI Number Information
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NPI Number | 1376470708
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Entity Type | Individual
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Provider Name | BROOKE ELIZABETH THATCHER
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Gender | Female
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Dates
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Enumeration Date | 05/07/2026
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Last Update Date | 05/07/2026
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Provider Practice Location Address
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Address Line | 150 SAINT PETERS CENTRE BLVD STE B
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City | SAINT PETERS
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State | MO
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Zip | 63376-1653
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Country | US
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Telephone | 636-466-8497
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Fax |
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Provider Business Mailing Address
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Address Line | 238 SEAWIND DR APT F
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City | BALLWIN
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State | MO
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Zip | 63021-4852
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Country | US
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Telephone | 573-837-9814
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2026018837
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License Number State | MO
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