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Individual

MRS. KELLY KUBALA MEHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.C.S.W

Contact information

Practice address
408 JEFFERSON STREET, ST. CHARLES, MO 63301
(314) 440-5800
Mailing address
5854 WALSH ST, SAINT LOUIS, MO 63109-3120
(314) 440-5800

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2006018306
MO

Other

Enumeration date
06/28/2007
Last updated
10/18/2013
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