Individual
KEITH ELLIOTT DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4249 CLAYTON AVE, SAINT LOUIS, MO 63110-1718
(314) 206-3700
Mailing address
3309 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63139-1101
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2008005851
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008005851
MO DIVISION OF PROFESSIONAL REGISTRATION
MO
Enumeration date
02/26/2019
Last updated
01/12/2024
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