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NPI Code Detail

MEDICARE: AMOUR COUPLES AND FAMILY THERAPY LLC

MEDICARE: AMOUR COUPLES AND FAMILY THERAPY LLC
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 Therapist2016006062MO

General Provider Information

NPI Number : 1417463696
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMOUR COUPLES AND FAMILY THERAPY LLC
Provider Business Mailing Address
First Line : 2047 FALLING BROOK DR
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-2209
Country : US
Telephone Number : 314-368-4734
Fax Number :
Provider Business Practice Location Address
First Line : 1034 S BRENTWOOD BLVD STE 555
Second Line :
City : RICHMOND HEIGHTS
State : MO
Zip : 63117-1265
Country : US
Telephone Number : 314-368-4734
Fax Number :
Authorized Official
Title or Position : PRESIDENT/CEO
Name : TIFFANY LOUISE SIDNEY
Credential : MS, LMFT
Telephone Number : 314-368-4734
Provider Enumeration Date : 12/25/2017
Last Update Date : 01/15/2018

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Directions to “AMOUR COUPLES AND FAMILY THERAPY LLC ” Practice Location

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