Individual
MS. CORLISS REGINA BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
(314) 289-6496
Mailing address
3978 BOWEN ST APT 2A, SAINT LOUIS, MO 63116-3145
(314) 398-8062
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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