Provider Demographics
NPI:1669809133
Name:JUEHRING, RACHAEL LISA (PHD)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:LISA
Last Name:JUEHRING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11365 DORSETT RD.
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043
Mailing Address - Country:US
Mailing Address - Phone:314-872-6400
Mailing Address - Fax:314-454-4013
Practice Address - Street 1:11365 DORSETT RD.
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043
Practice Address - Country:US
Practice Address - Phone:314-872-6400
Practice Address - Fax:314-454-4013
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013034315103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical