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General NPI Number Information
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NPI Number | 1861512733
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Entity Type | Organization
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Legal Business Name | MARSHA KAREN MOORE ANDREOFF
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 777 S NEW BALLAS RD SUITE 129 WEST
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8705
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Country | US
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Telephone | 314-432-4556
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Fax | 314-997-8874
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Provider Business Mailing Address
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Address Line | 9117 CLAYTON RD
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City | SAINT LOUIS
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State | MO
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Zip | 63124-1801
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Country | US
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Telephone | 314-432-1845
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Fax |
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Authorized Official
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Title or Position | L.P.C.
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Name | MARSHA ANDREOFF
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Credential | M.A.
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Telephone | 314-432-4556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 000066
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License Number State | MO
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