Individual
MRS. KATELYN ELIZABETH VISCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LPC
Contact information
Practice address
12818 TESSON FERRY RD STE 103, SAINT LOUIS, MO 63128-2945
(314) 912-4655
Mailing address
10436 BIMINI DR, SAINT LOUIS, MO 63123-5922
(314) 288-5652
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2022028902
MO
101YP2500X
Professional Counselor
Primary
2022028902
MO
Other
Enumeration date
06/18/2024
Last updated
08/30/2024
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