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1265066880
MISTIE ANN TENNANT
BELLEVILLE, IL
NPI
1265066880
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IL 180.012771)
Enumeration Date
2020-02-24
Last Update Date
2023-03-16
Business Address
MISTIE ANN TENNANT LCPC
115 LINCOLN PLACE CT STE 102
BELLEVILLE, IL 62221
Phone number: 314-643-8664
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Mailing Address
MISTIE ANN TENNANT LCPC
115 LINCOLN PLACE CT STE 102
BELLEVILLE, IL 62221-5876
Phone number: 314-643-8664
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