Individual
KATHERINE LIN BOUVATTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
12125 WOODCREST EXECUTIVE DR STE 110, SAINT LOUIS, MO 63141-5009
(314) 275-8599
(314) 275-8299
Mailing address
824 COLEBROOK DR, SAINT LOUIS, MO 63119-4118
(314) 306-5955
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2017005114
MO
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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