Individual
JENNA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12303 DEPAUL DR, SAINT LOUIS, MO 63044
(314) 344-6000
Mailing address
1426 CARRIAGE BRIDGE TRL, BALLWIN, MO 63021-8426
(314) 307-3407
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2007027738
MO
174400000X
Specialist
2007027738
MO
Other
Enumeration date
10/13/2010
Last updated
09/07/2016
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