Provider Demographics
NPI:1154440485
Name:BRUCE, KAMILA SHEREE WHITE (PHD)
Entity Type:Individual
Prefix:PROF
First Name:KAMILA
Middle Name:SHEREE WHITE
Last Name:BRUCE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7606 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3863
Mailing Address - Country:US
Mailing Address - Phone:314-516-7122
Mailing Address - Fax:314-516-5392
Practice Address - Street 1:1 UNIVERSITY BLVD
Practice Address - Street 2:STADLER HALL
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-4400
Practice Address - Country:US
Practice Address - Phone:314-516-7122
Practice Address - Fax:314-516-5392
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006006603103TC0700X
MA7848103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical