Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | MO |
NPI | 1053906768 |
---|---|
Provider Name | Rachael Cherie Beach Woerther |
First Address | Saint Louis, MO 63131-2599 |
Second Address | Saint Louis, MO 63131-2599 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2021 |
Last Update Date | 04/03/2021 |