Provider Demographics
NPI:1801973268
Name:DUPREE, ALBERT F (PHD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:F
Last Name:DUPREE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:AL
Other - Middle Name:
Other - Last Name:DUPREE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1933 ARSENAL ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63118-2502
Mailing Address - Country:US
Mailing Address - Phone:314-258-3984
Mailing Address - Fax:314-773-0067
Practice Address - Street 1:807 COLLINS DR
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-2346
Practice Address - Country:US
Practice Address - Phone:636-931-4206
Practice Address - Fax:636-931-5774
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001010840103T00000X
TX33404103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOPENDINGMedicaid
MOPENDINGMedicaid