MEDICARE: MARION POOLE PLPC

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	101YP2500X	Professional Counselor	2013029336	MO

General Provider Information

NPI Number	:	1699175877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARION POOLE PLPC

Provider Business Mailing Address
First Line	:	7281 OLIVE BLVD
Second Line	:
City	:	UNIVERSITY CITY
State	:	MO
Zip	:	63130-2323
Country	:	US
Telephone Number	:	314-403-2360
Fax Number	:

Provider Business Practice Location Address
First Line	:	7281 OLIVE BLVD
Second Line	:
City	:	UNIVERSITY CITY
State	:	MO
Zip	:	63130-2323
Country	:	US
Telephone Number	:	314-403-2360
Fax Number	:

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

Provider Enumeration Date	:	08/25/2014
Last Update Date	:	08/25/2014

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Directions to “ MARION POOLE PLPC” Practice Location

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