Individual
JAMA GAY ANTHONY-PETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
11222 TESSON FERRY RD, SUITE 200, SAINT LOUIS, MO 63123-6963
(314) 971-3051
(314) 822-7562
Mailing address
859 SHERILIN DR, KIRKWOOD, MO 63122-2324
(314) 971-3051
(314) 822-7562
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW001334
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SWOO1334
LCSW
MO
Enumeration date
06/19/2007
Last updated
07/08/2007
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