Individual
MADISON DEROUSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
214 CLAY STREET, SUITE 215, KIRKWOOD, MO 63122
(573) 880-6536
Mailing address
214 N CLAY AVE STE 215, KIRKWOOD, MO 63122-4068
(573) 880-6536
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2024014799
MO
Other
Enumeration date
11/30/2023
Last updated
05/14/2025
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