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Individual

MS. LEE AMES BASCOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
1121 OLIVETTE EXECUTIVE PWKY STE 205, SAINT LOUIS, MO 63132-1641
(314) 991-9058
(314) 993-2050
Mailing address
841 N KIRKWOOD ROAD, SAINT LOUIS, MO 63122-2639
(360) 628-8612

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2004031739
MO

Other

Enumeration date
05/19/2011
Last updated
01/31/2021
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