Provider Demographics
NPI:1639406523
Name:KIRCHER, NENA L (PLP)
Entity Type:Individual
Prefix:
First Name:NENA
Middle Name:L
Last Name:KIRCHER
Suffix:
Gender:F
Credentials:PLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 ABERDEEN CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-3860
Mailing Address - Country:US
Mailing Address - Phone:417-773-9444
Mailing Address - Fax:
Practice Address - Street 1:116 S LINCOLN DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MO
Practice Address - Zip Code:63379-1418
Practice Address - Country:US
Practice Address - Phone:636-528-8199
Practice Address - Fax:636-528-1833
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009031275103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical