Provider Demographics
NPI:1255573978
Name:BOURNE, STEVE (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:
Last Name:BOURNE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY BLVD
Mailing Address - Street 2:DEPT. OF PSYCHOLOGY, UNIVERSITY OF MISSOURI-ST. LOUIS
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-4400
Mailing Address - Country:US
Mailing Address - Phone:314-516-5824
Mailing Address - Fax:314-516-6624
Practice Address - Street 1:1 UNIVERSITY BLVD
Practice Address - Street 2:DEPT. OF PSYCHOLOGY, UNIVERSITY OF MISSOURI-ST. LOUIS
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-4400
Practice Address - Country:US
Practice Address - Phone:314-516-5824
Practice Address - Fax:314-516-5347
Is Sole Proprietor?:No
Enumeration Date:2009-03-26
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2009004846103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical