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1376701847
BRIAN E ELLEDGE
SAINT PETERS, MO
NPI
1376701847
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: MO 1999141447)
Enumeration Date
2008-05-30
Last Update Date
2008-05-30
Business Address
MR. BRIAN E ELLEDGE MA, LPC
4905 MEXICO RD SUITE 300
SAINT PETERS, MO 63376-1614
Phone number: 636-928-5109
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Mailing Address
MR. BRIAN E ELLEDGE MA, LPC
5000 CEDAR PLAZA PKWY SUITE 350
SAINT LOUIS, MO 63128-3854
Phone number: 314-843-4333
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