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General NPI Number Information
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NPI Number | 1497552343
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Entity Type | Individual
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Provider Name | ANGELA CHRISTINE KOVARIK MED, EDS, NCSP
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Gender | Female
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 1020 S SAPPINGTON RD
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City | SAINT LOUIS
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State | MO
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Zip | 63126-1005
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Country | US
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Telephone | 324-729-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 S SAPPINGTON RD
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City | SAINT LOUIS
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State | MO
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Zip | 63126-1005
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Country | US
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Telephone | 314-729-2400
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 397061
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License Number State | MO
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