Provider Demographics
NPI:1609290162
Name:WEEKE, TERESA LOUISE I (PLPC)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:LOUISE
Last Name:WEEKE
Suffix:I
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9378 OLIVE BLVD STE 317
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-3224
Mailing Address - Country:US
Mailing Address - Phone:314-994-9344
Mailing Address - Fax:314-994-3007
Practice Address - Street 1:9378 OLIVE BLVD STE 317
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-3224
Practice Address - Country:US
Practice Address - Phone:314-994-9344
Practice Address - Fax:314-994-3007
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012019759101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor