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General NPI Number Information
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NPI Number | 1528412681
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Entity Type | Organization
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Legal Business Name | WILFRED J KRENN, PSYCHOTHERAPIST
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 04/14/2016
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Provider Practice Location Address
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Address Line | 449 N EUCLID AVE SUITE 110
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1681
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Country | US
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Telephone | 314-254-3222
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Fax |
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Provider Business Mailing Address
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Address Line | 449 N EUCLID AVE SUITE 110
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1681
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MR. WILFRED JOSEPH KRENN JR.
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Credential | MA, LPC
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Telephone | 314-254-3222
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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 | 2010028143
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License Number State | MO
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