Organization
KIDNEY WELLCARE & COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRON E RUTLEDGE LCSW (CEO/OWNER)
(614) 425-2604
Entity
Organization
Contact information
Practice address
9666 OLIVE BLVD STE 205, OLIVETTE, MO 63132-3025
(614) 425-2604
Mailing address
13439 FORESTLAC DR, SAINT LOUIS, MO 63141-6005
(614) 425-2604
(636) 216-1987
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
133V00000X
Registered Dietitian
—
—
133VN1005X
Renal Nutrition Registered Dietitian
—
—
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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