Individual
MARY ELLEN HUBBARD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
109 N MILL ST, FESTUS, MO 63028-1815
(636) 937-2157
(636) 937-3172
Mailing address
9200 WATSON RD, SUITE G101, SAINT LOUIS, MO 63126-1528
(314) 367-5500
(314) 843-9212
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2000172219
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
155602
BLUE CROSS
MO
01
—
451501
HEALTHLINK
MO
Enumeration date
02/01/2006
Last updated
07/08/2007
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