Provider Demographics
NPI:1689685737
Name:MEIDINGER, MARY FRANCES (LICENSED PROFESSIONA)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:FRANCES
Last Name:MEIDINGER
Suffix:
Gender:F
Credentials:LICENSED PROFESSIONA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:112 W. JEFFERSON AVE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-4200
Mailing Address - Country:US
Mailing Address - Phone:314-276-9591
Mailing Address - Fax:314-689-0376
Practice Address - Street 1:112 W. JEFFERSON AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-4200
Practice Address - Country:US
Practice Address - Phone:314-276-9591
Practice Address - Fax:314-689-0376
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCS001662101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health