Individual
KATIE MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1150 GRAHAM RD STE 101&102, FLORISSANT, MO 63031-8077
(314) 206-3900
Mailing address
9860 BREEDS HILL DR APT D, AFFTON, MO 63123-4212
(314) 971-9019
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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