Individual
ELIZABETH TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
21 ST MALO CT, LAKE ST LOUIS, MO 63367-1912
(636) 578-4921
Mailing address
21 ST MALO CT, LAKE ST LOUIS, MO 63367-1912
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2008015257
MO
Other
Enumeration date
05/10/2017
Last updated
05/10/2017
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