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1861910754
ANDREA NISSENBAUM
SAINT LOUIS, MO
NPI
1861910754
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MO 2021008193)
Enumeration Date
2017-08-31
Last Update Date
2022-11-28
Business Address
ANDREA NISSENBAUM
1430 OLIVE ST STE 500
SAINT LOUIS, MO 63103-2377
Phone number: 314-453-9851
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Mailing Address
ANDREA NISSENBAUM
4106 OLIVE ST
SAINT LOUIS, MO 63108-3126
Phone number: 314-703-8410
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