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1043468556
SUSAN MARIE FAGAN
SAINT LOUIS, MO
NPI
1043468556
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MO 2004032923)
Enumeration Date
2008-09-09
Last Update Date
2008-10-20
Business Address
Mrs. SUSAN MARIE FAGAN L.P.C., R.N.
12125 WOODCREST EXECUTIVE DR SUITE 110
SAINT LOUIS, MO 63141-5001
Phone number: 314-275-8599
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Mailing Address
Mrs. SUSAN MARIE FAGAN L.P.C., R.N.
10820 SUNSET OFFICE DR SUITE 122
SAINT LOUIS, MO 63127-1016
Phone number: 314-954-6553
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