Individual
JAZELL DAILEY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC,NCC
Contact information
Practice address
11520 SAINT CHARLES ROCK RD STE 103, BRIDGETON, MO 63044-2732
(314) 312-2551
Mailing address
1055 TRIFECTA DR, FLORISSANT, MO 63034-3339
(314) 359-5334
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2018029057
MO
Other
Enumeration date
04/19/2019
Last updated
04/19/2019
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