Organization
INTEGRATED NEUROSCIENCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN PALMER CRUM LCPC (CLINICAL DIRECTOR)
(314) 997-2296
Entity
Organization
Contact information
Practice address
11477 OLDE CABIN RD, SUITE 210, SAINT LOUIS, MO 63141-7130
(314) 997-2296
(314) 997-5368
Mailing address
11477 OLDE CABIN RD, SUITE 210, SAINT LOUIS, MO 63141-7130
(314) 997-2296
(314) 997-5368
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2007012895
MO
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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