Organization
CHILD AND ADOLESCENT LIFE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY L LUSTER LPC (MENTAL HEALTH THERAPIST)
(314) 440-8468
Entity
Organization
Contact information
Practice address
4390 LINDELL BLVD STE 200, SAINT LOUIS, MO 63108-2735
Mailing address
4390 LINDELL BLVD STE 200, SAINT LOUIS, MO 63108-2735
(314) 744-9002
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
05/25/2019
Last updated
05/25/2019
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