Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 1999140371 | MO |
NPI | 1104029727 |
---|---|
Provider Name | Dr. Christine Marie Rankin |
First Address | Saint Louis, MO 63141-7029 |
Second Address | Saint Louis, MO 63141-7029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2007 |
Last Update Date | 13/05/2008 |