Individual
MS. REBECCA LYNN SIDWELL-DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14377 WOODLAKE DR, SUITE 308, CHESTERFIELD, MO 63017-5735
(314) 576-6493
(314) 576-7319
Mailing address
14377 WOODLAKE DR, SUITE 308, CHESTERFIELD, MO 63017-5735
(314) 576-6493
(314) 576-7319
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2005028054
MO
Other
Enumeration date
07/24/2007
Last updated
08/22/2007
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