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NPI Code Detail

MEDICARE: MARK STEVEN SIEGEL PH.D., MFT

MEDICARE:   MARK STEVEN SIEGEL  PH.D., MFT
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
1106H00000XMarriage & Family Therapist2003017812MO

General Provider Information

NPI Number : 1124234232
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK STEVEN SIEGEL PH.D., MFT
Provider Business Mailing Address
First Line : 7631 STANFORD AVE
Second Line :
City : UNIVERSITY CITY
State : MO
Zip : 63130-2839
Country : US
Telephone Number : 314-727-1714
Fax Number : 314-727-1714
Provider Business Practice Location Address
First Line : 7631 STANFORD AVE
Second Line :
City : UNIVERSITY CITY
State : MO
Zip : 63130-2839
Country : US
Telephone Number : 314-727-1714
Fax Number : 314-727-1714
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 07/08/2007

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Directions to “ MARK STEVEN SIEGEL PH.D., MFT” Practice Location

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