Individual provider · Type 1 NPI

Azra Tiedt

Mental Health Counselor · Bridgeton, MO

NPI number 1073738837 Active

Practice location

3165 Mckelvey Rd, Suite 200
Bridgeton, MO 63044-2550

Fax (314) 206-3992

Mailing address

1430 Olive St, Suite 400
St. Louis, MO 63103-2303

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1073738837

Azra Tiedt's National Provider Identifier is 1073738837, issued on Apr 16, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Bridgeton, MO. The record was last updated on Jul 8, 2007.