Provider Demographics
NPI:1306049515
Name:UGARTE, LETICIA (MD)
Entity type:Individual
Prefix:DR
First Name:LETICIA
Middle Name:
Last Name:UGARTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:255 SPENCER RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2576
Mailing Address - Country:US
Mailing Address - Phone:636-939-2550
Mailing Address - Fax:636-939-2551
Practice Address - Street 1:255 SPENCER RD STE 201
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2576
Practice Address - Country:US
Practice Address - Phone:636-939-2550
Practice Address - Fax:636-939-2551
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070135442084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry