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Individual

KIA WYATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3026 LACLEDE AVE, SAINT LOUIS, MO 63103-2136
(314) 340-5089
Mailing address
6409 CATES AVE APT 1W, UNIVERSITY CITY, MO 63130-3441

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MO

Other

Enumeration date
02/04/2026
Last updated
02/04/2026
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