Provider Demographics
NPI:1114761087
Name:SELTZER, ASHLEE MARIE (PLPC)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:MARIE
Last Name:SELTZER
Suffix:
Gender:
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-1489
Mailing Address - Country:US
Mailing Address - Phone:314-802-2615
Mailing Address - Fax:314-842-2552
Practice Address - Street 1:11166 TESSON FERRY RD STE 300
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-6966
Practice Address - Country:US
Practice Address - Phone:314-533-8200
Practice Address - Fax:314-842-2552
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025010939101YP2500X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program