Individual
BREANNA LYNN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1167 CORPORATE LAKE DR, SAINT LOUIS, MO 63132-1716
(314) 534-9350
Mailing address
3309 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63139-1101
(314) 534-9350
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2020034451
MO
Other
Enumeration date
07/14/2022
Last updated
07/14/2022
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