Individual
KATE REVELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
804 WINDINGPATH LN, MANCHESTER, MO 63021-6636
(636) 667-9691
Mailing address
804 WINDINGPATH LN, MANCHESTER, MO 63021-6636
(636) 667-9691
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2018028472
MO
Other
Enumeration date
12/17/2021
Last updated
12/17/2021
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