Provider Demographics
NPI:1649505330
Name:MICHLER, THOMAS LEE (MED)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:LEE
Last Name:MICHLER
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9060 WATSON RD STE C
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-2200
Mailing Address - Country:US
Mailing Address - Phone:314-239-4484
Mailing Address - Fax:314-849-4617
Practice Address - Street 1:9060 WATSON RD STE C
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-2200
Practice Address - Country:US
Practice Address - Phone:314-239-4484
Practice Address - Fax:314-849-4617
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006035624101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional