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Individual

DR. BRYAN CHARLES DUCKHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD, MSW, LCSW

Contact information

Practice address
12125 WOODCREST EXEC. DRIVE STE 110, ST. LOUIS, MO 63141
(314) 275-8599
(314) 275-8299
Mailing address
12125 WOODCREST EXEC. DRIVE STE 110, ST. LOUIS, MO 63141
(314) 275-8599
(314) 275-8299

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
366
MO

Other

Enumeration date
03/03/2015
Last updated
03/03/2015
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