Individual
CONSUELO MATURANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7505 PERSHING AVE APT 2W, SAINT LOUIS, MO 63130-4024
(314) 223-5754
Mailing address
7505 PERSHING AVE APT 2W, SAINT LOUIS, MO 63130-4024
(314) 223-5754
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
2000143549
MO
Other
Enumeration date
08/17/2017
Last updated
07/21/2022
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