Individual
KRYSTAL KAY DEWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2743 RUSSELL BLVD, SAINT LOUIS, MO 63104-2137
(573) 864-9743
Mailing address
4463 HESTERS WAY, SAINT CHARLES, MO 63304-7756
(636) 795-8784
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003653
MO
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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