Individual
MS. JENNIFER REBECCA BEAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1412 BALI CT, SAINT LOUIS, MO 63126-1607
(314) 610-0679
Mailing address
1412 BALI CT, SAINT LOUIS, MO 63126-1607
(314) 610-0679
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2009030435
MO
Other
Enumeration date
09/03/2015
Last updated
08/23/2021
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