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1063146199
BREANNA LYNN DOUGLAS
SAINT LOUIS, MO
NPI
1063146199
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MO 2020034451)
Enumeration Date
2022-07-14
Last Update Date
2022-07-14
Business Address
BREANNA LYNN DOUGLAS LCSW
1167 CORPORATE LAKE DR
SAINT LOUIS, MO 63132-1716
Phone number: 314-534-9350
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Mailing Address
BREANNA LYNN DOUGLAS LCSW
3309 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63139-1101
Phone number: 314-534-9350
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