Basic Information
| Provider Information | |||||||||
| NPI: | 1720453749 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SKIERA-NOVOTNY | ||||||||
| FirstName: | MEGAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 227 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FESTUS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630281952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6369312700 | ||||||||
| FaxNumber: | 6369315304 | ||||||||
| Practice Location | |||||||||
| Address1: | 4 HICKORY RIDGE RD STE 600 | ||||||||
| Address2: | |||||||||
| City: | HILLSBORO | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630505117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6364816040 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2015 | ||||||||
| LastUpdateDate: | 07/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 2019048002 | MO | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.