Individual
HENRY NDUBUISI ADIELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
ST. LOUIS GREAT CIRCLE CAMPUS, 330 N. GORE AVENUE, WEBSTER GROVES, MO 63119
(314) 301-4650
(314) 301-4652
Mailing address
11054 WORCHESTER DR, SAINT LOUIS, MO 63136-5829
(314) 441-9059
(314) 395-1000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2022032912
MO
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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