Provider Demographics
NPI:1730312570
Name:MONROW, PERRIS JOSEPH
Entity Type:Individual
Prefix:DR
First Name:PERRIS
Middle Name:JOSEPH
Last Name:MONROW
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:PERRIS
Other - Middle Name:JOSEPH
Other - Last Name:MONROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:11222 TESSON FERRY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-6963
Mailing Address - Country:US
Mailing Address - Phone:618-363-6033
Mailing Address - Fax:618-462-6410
Practice Address - Street 1:711 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6025
Practice Address - Country:US
Practice Address - Phone:618-363-6033
Practice Address - Fax:618-462-6410
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008022215103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling