Individual
REBA RICE-PORTWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3633 MARIETTA DR STE C, FLORISSANT, MO 63033-3208
(314) 831-5433
Mailing address
3633 MARIETTA DR STE C, FLORISSANT, MO 63033-3208
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2015006046
MO
Other
Enumeration date
07/30/2015
Last updated
07/30/2015
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