Organization
UNIQUE DIAMONDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTIE TYSON LPC (THERAPIST)
(314) 828-9713
Entity
Organization
Contact information
Practice address
4068 MAFFITT, ST. LOUIS, MO 63113
(314) 828-9713
Mailing address
1147 APPLESEED LN, APT A, OLIVETTE, MO 63132
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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