Individual
MS. KIMBERLY YVETTE MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAADC I
Contact information
Practice address
9733 SAINT CHARLES ROCK RD, SAINT LOUIS, MO 63114-2625
(314) 423-7030
(314) 423-9511
Mailing address
5512 MABLE AVE APT B3, SAINT LOUIS, MO 63140-1414
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/01/2026
Last updated
01/01/2026
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