Individual
MIA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1570 S MAIN ST, SAINT CHARLES, MO 63303-4149
(636) 224-1000
Mailing address
470 E LOCKWOOD AVE, SAINT LOUIS, MO 63119-3194
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/03/2026
Last updated
02/03/2026
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