Individual
REBECCA ANN MATERNIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
140 PROFESSIONAL PKWY, TROY, MO 63379-2823
(636) 528-5911
Mailing address
1421 PIEDMONT CIR, SAINT PETERS, MO 63304-5680
(636) 542-1100
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2016008460
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016008460
LICENSED PROFESSIONAL COUNSELOR
MO
Enumeration date
06/14/2017
Last updated
03/17/2018
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