JERRY TABAK

O FALLON, MO
NPI1114276342
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MO  002217)
Enumeration Date2012-09-04
Last Update Date2012-09-04
Business Address
-- JERRY TABAK LCSW
109 CHURCH ST SUITE 105
O FALLON, MO 63366-2894
Phone number: 636-294-0015
Mailing Address
-- JERRY TABAK LCSW
109 CHURCH ST SUITE 105
O FALLON, MO 63366-2894
Phone number: 636-294-0015
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