MEDICARE: ERIN MOLES

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	101YM0800X	Mental Health Counselor	2011008108	MO

General Provider Information

NPI Number	:	1669801056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN MOLES

Provider Business Mailing Address
First Line	:	1520 WASHINGTON AVE
Second Line	:	UNIT 513
City	:	SAINT LOUIS
State	:	MO
Zip	:	63103-1840
Country	:	US
Telephone Number	:	314-629-2321
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 W ARGONNE DR
Second Line	:	SUITE G
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-4237
Country	:	US
Telephone Number	:	314-629-2321
Fax Number	:

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

Provider Enumeration Date	:	11/05/2013
Last Update Date	:	11/15/2013

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Directions to “ ERIN MOLES ” Practice Location

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