Dale, Corrine Ann

Dale, Corrine Ann is an sole proprietor health care provider with primary practice located at 1408 Farmview Ave , Saint Louis MO 63138-2515. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is her primary health care specialty. Dale, Corrine Ann can be contacted via phone (314) 216-0199.

Contact Information

Primary practice address
1408 Farmview Ave Saint Louis MO 63138-2515
Phone: (314) 216-0199
Fax: (314) 741-8992
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2002026438 Missouri
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X W236154637 Illinois

Profile Details

NPI number 1568660447
LBN Legal business name Dale, Corrine Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 3rd, 2007
Last updated Sep 12th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568660447 NPPES
Missouri MEDICAID 497178301

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