Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 2002021870 | MO |
NPI | 1003970401 |
---|---|
Provider Name | Dr. Erikalin Nichole Ashton |
First Address | Saint Louis, MO 63109-1516 |
Second Address | Saint Louis, MO 63124-1685 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 23/07/2012 |