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1003939323
GLENNON CHARLES DOHERTY
KIRKWOOD, MO
NPI
1003939323
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MO 002525)
Enumeration Date
2007-04-10
Last Update Date
2007-07-08
Business Address
Mr. GLENNON CHARLES DOHERTY M.ED., LPC
214 S CLAY AVE APT. 3
KIRKWOOD, MO 63122-4215
Phone number: 314-849-2989
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Mailing Address
Mr. GLENNON CHARLES DOHERTY M.ED., LPC
214 S CLAY AVE APT. 3
KIRKWOOD, MO 63122-4215
Phone number: 314-849-2989
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T.A.V.E.R.N. HEALTH AND WELLNESS, LLC