Individual
DONNA FANTOZZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1217 WOODLAND POINT DR., UNIT L, ST. LOUIS, MO 63146-1837
(314) 906-0054
(314) 469-3523
Mailing address
1217 WOODLAND POINT DRIVE, UNIT L, ST. LOUIS, MO 63146-1837
(314) 906-0054
(314) 469-3523
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002713
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
182434
BLUE CROSS BLUE SHIELD
MO
Enumeration date
08/15/2006
Last updated
07/08/2007
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