Individual
MAGGIE M GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
2705 MULLANPHY LN, FLORISSANT, MO 63031-3727
(314) 830-6207
(314) 830-6257
Mailing address
3654 BELLERIVE BLVD, SAINT LOUIS, MO 63116-3231
(314) 503-3038
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4490
MO
1041C0700X
Clinical Social Worker
Primary
2010014770
MO
Other
Enumeration date
01/08/2009
Last updated
08/10/2010
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