Provider Demographics
NPI:1477677524
Name:RESCHKE, ANAT H (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANAT
Middle Name:H
Last Name:RESCHKE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10420 OLD OLIVE STREET RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141
Mailing Address - Country:US
Mailing Address - Phone:314-991-9700
Mailing Address - Fax:314-991-7779
Practice Address - Street 1:10420 OLD OLIVE STREET RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-991-9700
Practice Address - Fax:314-991-7779
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001024796103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO149532OtherBLUE CROSS BLUE SHIELD
MO466844OtherHEATHLINK
MO149532OtherBLUE CROSS BLUE SHIELD