Individual
JENNIFER DAYLE KING BROGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRADC, MARS, CH
Contact information
Practice address
3309 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63139-1101
(314) 206-3708
Mailing address
197 CROSSWINDS DR, ARNOLD, MO 63010-2018
(636) 204-9766
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4111
MO
Other
Enumeration date
04/18/2020
Last updated
09/27/2024
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