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Organization
TEA TREE BEHAVIORAL HEALTH & THERAPY LLC
Active
Organization
TEA TREE BEHAVIORAL HEALTH & THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MARIE GILMAN MSW, LCSW (CLINICAL SOCIAL WORKER/OWNER)
(636) 484-4371
Entity
Organization
Contact information
Practice address
102 S MCKINLEY AVE, UNION, MO 63084-1814
(636) 484-4371
Mailing address
5323 MIRASOL MANOR WAY, EUREKA, MO 63025-2751
(636) 484-4371
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2013008645
MO
101YP2500X
Professional Counselor
2013041575
MO
1041C0700X
Clinical Social Worker
Primary
2011028460
MO
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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