Organization
ST. LOUIS EATING RECOVERY THERAPY, LLC
Active
Organization
ST. LOUIS EATING RECOVERY THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE JACOBS LPC, CEDS-S (OWNER/THERAPIST)
(314) 609-1874
Entity
Organization
Contact information
Practice address
140 PROSPECT AVE STE L, KIRKWOOD, MO 63122-6024
(314) 896-0810
Mailing address
637 S PAM AVE, SAINT CHARLES, MO 63301-4866
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/24/2021
Last updated
04/24/2021
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