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1225002447
RAYMOND C TAIT
ST LOUIS, MO
NPI
1225002447
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist Clinical
(Licence: MO 01087)
Enumeration Date
2006-02-14
Last Update Date
2008-01-09
Business Address
RAYMOND C TAIT PHD
1221 S GRAND
ST LOUIS, MO 63104
Phone number: 314-268-5424
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Mailing Address
RAYMOND C TAIT PHD
3691 RUTGER AVE PROVIDER ENROLLMENT
ST LOUIS, MO 63110
Phone number: 314-977-4440
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