Provider Demographics
NPI:1942224407
Name:MORSE, SUSAN MEECHAM (PHD)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MEECHAM
Last Name:MORSE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:MEECHAM
Other - Last Name:REIDHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:12255 DEPAUL DR
Mailing Address - Street 2:SUITE 250 MEDICAL BLDG NORTH
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63044
Mailing Address - Country:US
Mailing Address - Phone:314-344-7880
Mailing Address - Fax:314-298-0556
Practice Address - Street 1:12255 DEPAUL DR
Practice Address - Street 2:SUITE 250 MEDICAL BLDG NORTH
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63044
Practice Address - Country:US
Practice Address - Phone:314-344-7880
Practice Address - Fax:314-298-0556
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01230103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist