Individual
KATHERINE LONDON KIENTZLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA PLPC
Contact information
Practice address
11709 OLD BALLAS RD, SUITE 103, SAINT LOUIS, MO 63141-7029
(314) 432-2428
(314) 432-2222
Mailing address
930 WINDSOR CT, WEBSTER GROVES, MO 63119-3948
(314) 491-7003
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2009000557
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27-1272761
TAX IDENTIFICATION NUMBER
MO
Enumeration date
06/09/2010
Last updated
06/09/2010
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