Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 000673 | MO |
Y | 103T00000X | Psychologist | 000673 | MO |
NPI | 1013031806 |
---|---|
Provider Name | Dr. Robert Edward Schlitt |
First Address | Saint Louis, MO 63119-3919 |
Second Address | Saint Louis, MO 63119-3919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25879 | ANTHEM BCBS INSURANCE CO (01) | MO |