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NPI Code Detail

MEDICARE: KRISTINE ANGELO LMFT

MEDICARE: KRISTINE ANGELO LMFT
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 Therapist2011003480MO
2106H00000XMarriage & Family Therapist0000000839TN

General Provider Information

NPI Number : 1821383175
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINE ANGELO LMFT
Provider Business Mailing Address
First Line : 1034 S BRENTWOOD BLVD STE 555
Second Line :
City : RICHMOND HEIGHTS
State : MO
Zip : 63117-1265
Country : US
Telephone Number : 314-394-8757
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 : 314-394-8757
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2011
Last Update Date : 12/18/2022

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Directions to “ KRISTINE ANGELO LMFT” Practice Location

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