Individual
JENNIFER WALLACE EBELING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2017018577
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017018577
LPC
MO
Enumeration date
10/29/2018
Last updated
09/29/2022
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