Individual
MICKEY OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-7236
(314) 525-1886
Mailing address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-7236
(314) 525-1886
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003410
MO
Other
Enumeration date
08/07/2015
Last updated
03/15/2017
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