Individual
ALICIA D BUCK HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
449 N EUCLID AVE STE 300, SAINT LOUIS, MO 63108-1609
(314) 475-8532
Mailing address
449 N EUCLID AVE, SAINT LOUIS, MO 63108-1642
(314) 475-8532
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2017042558
MO
101YP2500X
Professional Counselor
2017042558
MO
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490051600
—
MO
05
—
500099408
—
MO
Enumeration date
07/05/2017
Last updated
11/16/2021
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