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Individual

ACACIA DOUGLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
7710 CARONDELET AVE STE 304, CLAYTON, MO 63105-3319
(314) 725-1515
Mailing address
521 FRANKLIN AVE, TROY, IL 62294-2105
(618) 553-4317

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
106H00000X
Marriage & Family Therapist
Primary
2020022446
MO

Other

Enumeration date
01/13/2020
Last updated
09/15/2022
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