Provider Information for 1508098757
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AMY EILERS LCSW
Sex: Female
NPI: 1508098757
Last Updated: 2018-03-17
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1508098757 | ||||||||||||
| Enumeration Date | 2009-08-20 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1733 MEADOW LN EDWARDSVILLE, IL 62025-3949 United States Phone: 618-558-4557 | Fax: | ||||||||||||
| Primary Practice Address | 3015 N BALLAS RD SAINT LOUIS, MO 63131-2329 United States Phone: 314-996-5669 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 110 N ELM AVE | ||||||||||||
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