Individual
KELLIE MARIE BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
1528 BRITTANY CV, COTTLEVILLE, MO 63304-7166
(573) 239-7102
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2015034789
MO
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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