Provider Demographics
NPI:1346643277
Name:PRESTON & ASSOCIATES PSYCHOLOGY FIRM, LLC
Entity Type:Organization
Organization Name:PRESTON & ASSOCIATES PSYCHOLOGY FIRM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:314-395-9437
Mailing Address - Street 1:4144 LINDELL BLVD
Mailing Address - Street 2:SUITE 317
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2927
Mailing Address - Country:US
Mailing Address - Phone:314-395-9437
Mailing Address - Fax:
Practice Address - Street 1:4144 LINDELL BLVD
Practice Address - Street 2:SUITE 317
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2927
Practice Address - Country:US
Practice Address - Phone:314-395-9437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008032664103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty