Individual
MS. LAURA JEAN CHILTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14026 S HIGHWAY 68, SAINT JAMES, MO 65559-6113
(773) 504-3291
Mailing address
14026 S HIGHWAY 68, SAINT JAMES, MO 65559-6113
(773) 504-3291
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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