Individual
JORDAN FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3338 WATSON RD, SAINT LOUIS, MO 63139-2000
(314) 252-8137
Mailing address
3338 WATSON RD, SAINT LOUIS, MO 63139-2000
(573) 864-7312
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2017027929
MO
1041C0700X
Clinical Social Worker
Primary
2019045963
MO
247200000X
Other Technician
—
—
Other
Enumeration date
06/30/2016
Last updated
01/04/2024
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