Individual
MELANTHA WITHERSPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
225 SAINT LOUIS AVENUE 35005, SAINT LOUIS, MO 63135-0505
(314) 369-7025
(314) 786-5429
Mailing address
P.O. BOX 35005, SAINT LOUIS, MO 63135-0505
(314) 369-7025
(314) 786-5429
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2007008766
MO
103K00000X
Behavior Analyst
2011023304
MO
Other
Enumeration date
05/21/2007
Last updated
05/01/2012
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