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Contact Information

ALICE G VLIETSTRA, PhD
745 CRAIG RD STE 102C
SAINT LOUIS, MO63141-7122
 Phone: 314-729-2855
 Fax: 314-529-3534
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Health Service

103TH0100X 62 Psychologist, Clinical
 

Marriage & Family Therapist

106H00000X
Indicates primary specialty

NPI Profile & details for ALICE G VLIETSTRA · (Female)

NPI Number 1841324753
Status Active
Credentials PhD
Entity Individual
Enumeration date 03/15/2007
Last updated 10/27/2025 - About 7 months ago
Sole proprietor 1 No
Identifiers
  • MO License # 01089
  • MO License # 300075
  • MO Other 1601 BLUE CROSS BLUE SHIELD
  • MO Other 075243 VALUE OPTIONS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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