Individual
KYLA BROEKER WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
47 ELLIS AVE, TROY, MO 63379-1151
(636) 357-1996
Mailing address
47 ELLIS AVE, TROY, MO 63379-1151
(636) 357-1996
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2002010834
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
495771313
—
MO
Enumeration date
02/05/2007
Last updated
12/30/2024
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