Individual
KAYLENE PORTELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
2617 MINNESOTA AVE, SAINT LOUIS, MO 63118-1305
(314) 884-1427
Mailing address
5016 DEVONSHIRE AVE, SAINT LOUIS, MO 63109-2405
(314) 808-5613
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2021012159
MO
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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