Individual
STAURLA CHANTEL WAUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10719 BUCKEYE RD, FESTUS, MO 63028
(314) 297-0793
Mailing address
510 W PINE ST, FARMINGTON, MO 63640-1426
(573) 756-2988
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
NLC.0108067
CO
103K00000X
Behavior Analyst
—
MO
Other
Enumeration date
04/25/2012
Last updated
04/08/2019
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