Organization
AGAPE CHRISTIAN COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRELL PROVINSE L.P.C. (EXECUTIVE DIRECTOR)
(314) 994-9344
Entity
Organization
Contact information
Practice address
9378 OLIVE BLVD, STE. 317, SAINT LOUIS, MO 63132-3215
(314) 994-9344
(314) 994-3007
Mailing address
9378 OLIVE BLVD, STE. 317, SAINT LOUIS, MO 63132-3215
(314) 994-9344
(314) 994-3007
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2004003789
MO
Other
Enumeration date
01/11/2007
Last updated
08/22/2020
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