Individual provider · Type 1 NPI

Paul Jeffrey Mack, CHTP, ED.D, MS, BA

Specialist · St. Louis, MO

NPI number 1780740563 Active

Practice location

1015 Mccausland Ave
St. Louis, MO 63117-1924

Call (314) 781-5050 Map

Mailing address

2960 Milton Blvd
St. Louis, MO 63104-1636

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X2504 (CO)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1780740563

Paul Jeffrey Mack, CHTP, ED.D, MS, BA's National Provider Identifier is 1780740563, issued on Dec 28, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in St. Louis, MO. The record was last updated on Jul 8, 2007.