Individual
GINA BRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2023023543
MO
1041C0700X
Clinical Social Worker
Primary
CSW.09926263
CO
Other
Enumeration date
08/17/2016
Last updated
01/09/2024
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