Provider Demographics
NPI:1871553164
Name:COX, AUGUSTA LEE (MA)
Entity type:Individual
Prefix:
First Name:AUGUSTA
Middle Name:LEE
Last Name:COX
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:AUGUSTA
Other - Middle Name:LEE
Other - Last Name:BAILEY-COX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:11125 DUNN RD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136
Mailing Address - Country:US
Mailing Address - Phone:314-837-4900
Mailing Address - Fax:314-837-5646
Practice Address - Street 1:11125 DUNN RD
Practice Address - Street 2:SUITE 213
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136
Practice Address - Country:US
Practice Address - Phone:314-837-4900
Practice Address - Fax:314-837-5646
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMOPY01146103TC0700X
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional