Provider Demographics
NPI:1073898557
Name:VELDERS, ABBIE MARIE
Entity Type:Individual
Prefix:MRS
First Name:ABBIE
Middle Name:MARIE
Last Name:VELDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ABBIE
Other - Middle Name:MARIE
Other - Last Name:MULITSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLPC
Mailing Address - Street 1:22 TREMAINE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-7541
Mailing Address - Country:US
Mailing Address - Phone:314-578-4788
Mailing Address - Fax:636-925-3159
Practice Address - Street 1:2850 W CLAY ST
Practice Address - Street 2:SUITE 255
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2573
Practice Address - Country:US
Practice Address - Phone:314-578-4788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011033932101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional