Individual
ANGELA GRACE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
47 ELLIS AVE, TROY, MO 63379-1151
(636) 775-2828
Mailing address
47 ELLIS AVE, TROY, MO 63379-1151
(636) 775-2828
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2023028886
MO
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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