Organization
THE COMMUNITY
Active
Other names
BTMB
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN SHELTON ED.S, ED.D, RSAP (CEO)
(314) 580-3029
Entity
Organization
Contact information
Practice address
8936 GOODFELLOW BLVD, SAINT LOUIS, MO 63147-1433
(314) 580-3029
Mailing address
8936 GOODFELLOW BLVD, SAINT LOUIS, MO 63147-1433
(314) 580-3029
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
225C00000X
MO
305S00000X
Point of Service
Primary
305S00000X
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9374
RSAP
MO
Enumeration date
09/20/2016
Last updated
09/20/2016
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