Individual
MRS. KELLY JEANNE BROTHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1085 MAPLE ST, FARMINGTON, MO 63640-1955
(573) 756-5353
(573) 756-4316
Mailing address
3309 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63139-1101
(314) 206-3700
(573) 756-4316
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2009023502
MO
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/27/2006
Last updated
02/02/2024
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