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Individual

MR. DWAINE DALE TIPTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW

Contact information

Practice address
10094 LITZSINGER RD, SAINT LOUIS, MO 63124-1132
(314) 989-8800
Mailing address
836 BROCKWELL DR, DARDENNE PRAIRIE, MO 63368-8370
(314) 779-7040

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2005005203

Other

Enumeration date
07/27/2006
Last updated
08/10/2023
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