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Individual

MS. DEIDRE MARIE RICHBURG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
1449 CANTWELL LN, APT 12, SWANSEA, IL 62226-7632
(618) 791-2387
Mailing address
1449 CANTWELL LN, APT 12, SWANSEA, IL 62226-7632
(618) 791-2387

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2008006348
MO
101YP2500X
Professional Counselor
Primary
2008006348
MO

Other

Enumeration date
03/07/2008
Last updated
03/07/2008
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