Organization
CLINICAL CONSULTANTS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A. CAMERON PH.D., M.A., L.P.C. (OWNER)
(314) 361-5347
Entity
Organization
Contact information
Practice address
1750 S BRENTWOOD BLVD, SUITE 559, SAINT LOUIS, MO 63144-1315
(314) 361-5347
(314) 918-8943
Mailing address
1750 S BRENTWOOD BLVD, SUITE 559, SAINT LOUIS, MO 63144-1315
(314) 361-5347
(314) 918-8943
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000898
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
856232707
—
MO
Enumeration date
04/11/2007
Last updated
06/20/2008
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