Hal I Pendergrass MA

NPI 1073677738 - Psychologist - 103TC0700X

NPI Details
NPI 1073677738
Gender Male
Enumeration Date 12/20/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
12131 DORSETT RD
SUITE 220
MARYLAND HEIGHTS MO, 63043-2418, US
Phone (314) 298-0900
Fax (314) 298-9274
Business Location
12131 DORSETT RD
SUITE 220
MARYLAND HEIGHTS MO, 63043-2418, US
Phone (314) 298-0900
Fax (314) 298-9274
Toxanomy
Taxonomy Code 103TC0700X
License State Missouri
License Number 01632
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According to our database, Hal I Pendergrass MA NPI is 1073677738, taxonomy code is 103TC0700X and license number is 01632, license state is located at Missouri. Hal I Pendergrass MA physically located at 12131 Dorsett Rd, Maryland Heights MO, 63043-2418. NPI Number Hal I Pendergrass MA has the Individual type.

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1073677738 NPI number is provided on an as is basis without warranty of any kind. 1073677738 is maintained by the National Plan & Provider Enumeration System. The contents of Hal I Pendergrass MA are for informational purposes only.