Provider Demographics
NPI:1750390035
Name:STRALKA, MARY JOSEPHA (PHD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:JOSEPHA
Last Name:STRALKA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13026 HUNTERCREEK RD
Mailing Address - Street 2:
Mailing Address - City:DES PERES
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2229
Mailing Address - Country:US
Mailing Address - Phone:314-965-4419
Mailing Address - Fax:314-965-2559
Practice Address - Street 1:13610 BARRETT OFFICE DR
Practice Address - Street 2:SUITE 108
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63021-7816
Practice Address - Country:US
Practice Address - Phone:314-965-2559
Practice Address - Fax:314-965-2559
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002411101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional