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General NPI Number Information
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NPI Number | 1760453682
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Entity Type | Individual
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Provider Name | JOAN A. HELLER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 05/24/2017
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Provider Practice Location Address
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Address Line | 7710 CARONDELET AVE STE 527
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City | CLAYTON
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State | MO
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Zip | 63105-0008
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Country | US
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Telephone | 314-725-1415
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Fax | 314-725-1378
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Provider Business Mailing Address
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Address Line | 1034 S BRENTWOOD BLVD SUITE 1601
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1223
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Country | US
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Telephone | 314-725-1415
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Fax | 314-725-1378
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 01449
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License Number State | MO
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