Individual
MISS JOAN BYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LCSW
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
7445 CORNELL AVE, SAINT LOUIS, MO 63130-2915
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003556
MO
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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