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NPI Code Detail

MEDICARE: MRS. KAREN D. WASOBA M.ED., L.P.C.

MEDICARE: MRS. KAREN D. WASOBA M.ED., 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
1101YP1600XPastoral Counselor2001011582MO
2101YP2500XProfessional Counselor2001011582MO

General Provider Information

NPI Number : 1184730137
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAREN D. WASOBA M.ED., L.P.C.
Provider Business Mailing Address
First Line : 2536 S OLD HIGHWAY 94 STE 104
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-5627
Country : US
Telephone Number : 314-299-5116
Fax Number : 636-447-3000
Provider Business Practice Location Address
First Line : 2536 S OLD HIGHWAY 94 STE 104
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-5627
Country : US
Telephone Number : 314-299-5116
Fax Number : 636-447-3000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2006
Last Update Date : 04/30/2014

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