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NPI Code Detail

MEDICARE: LINDA ANN PRYOR LPC

MEDICARE:   LINDA ANN PRYOR  LPC
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
1101YP2500XProfessional Counselor2000152570MO

General Provider Information

NPI Number : 1790803088
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA ANN PRYOR LPC
Provider Business Mailing Address
First Line : 5860 DE GIVERVILLE AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63112-1617
Country : US
Telephone Number : 314-727-6490
Fax Number :
Provider Business Practice Location Address
First Line : 5860 DE GIVERVILLE AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63112-1617
Country : US
Telephone Number : 314-727-6490
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 07/08/2007

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Directions to “ LINDA ANN PRYOR LPC” Practice Location

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