Individual
JACLYN MIXELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1612 S BIG BEND BLVD, SAINT LOUIS, MO 63117-2208
(314) 529-1391
Mailing address
1612 S BIG BEND BLVD, SAINT LOUIS, MO 63117-2208
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2025025003
MO
Other
Enumeration date
10/02/2025
Last updated
10/02/2025
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