Individual
JERISHA LACRAE RUTLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
1872 WOODHOLLOW DR APT 211, MARYLAND HEIGHTS, MO 63043-3957
(314) 625-6070
Mailing address
1872 WOODHOLLOW DR APT 211, MARYLAND HEIGHTS, MO 63043-3957
(314) 625-6070
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2015006047
MO
Other
Enumeration date
10/12/2017
Last updated
12/22/2022
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