Individual
LISA CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
141 N MERAMEC AVE, SUITE 109, CLAYTON, MO 63105-3750
(773) 980-6962
Mailing address
5533 CONNECTICUT ST, SUITE 109, SAINT LOUIS, MO 63139-1701
(773) 368-5956
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2013011413
MO
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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