MEDICARE: MS. MARY FRANCES MEIDINGER LICENSED PROFESSIONA

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	CS001662	MO

General Provider Information

NPI Number	:	1689685737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY FRANCES MEIDINGER LICENSED PROFESSIONA

Provider Business Mailing Address
First Line	:	112 W. JEFFERSON AVE
Second Line	:	SUITE 125
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-4200
Country	:	US
Telephone Number	:	314-276-9591
Fax Number	:	314-689-0376

Provider Business Practice Location Address
First Line	:	112 W. JEFFERSON AVE
Second Line	:	SUITE 125
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-4200
Country	:	US
Telephone Number	:	314-276-9591
Fax Number	:	314-689-0376

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	12/16/2013

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