MEDICARE: MRS. DEBORAH SUE ENGEL N.C.C., L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	2001022261	MO

General Provider Information

NPI Number	:	1093871113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH SUE ENGEL N.C.C., L.P.C.

Provider Business Mailing Address
First Line	:	217 W WOODBINE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-5822
Country	:	US
Telephone Number	:	314-221-2286
Fax Number	:	314-821-2863

Provider Business Practice Location Address
First Line	:	412 S CLAY AVE
Second Line	:	SUITE 201
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-5860
Country	:	US
Telephone Number	:	314-221-2286
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/01/2007
Last Update Date	:	07/09/2007

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