Individual
MR. RALPH WILLIAM GROOM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LBA
Contact information
Practice address
3877 HUMPHREY ST, SAINT LOUIS, MO 63116-4825
(314) 704-0900
Mailing address
3877 HUMPHREY ST, SAINT LOUIS, MO 63116-4825
(314) 704-0900
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
2013028554
MO
1041C0700X
Clinical Social Worker
Primary
2016004103
MO
Other
Enumeration date
08/06/2012
Last updated
04/27/2020
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