Individual
NICOLE BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, RPT, NBCC, MA
Contact information
Practice address
225 S MERAMEC AVE, SUITE 321T, CLAYTON, MO 63105-3511
(314) 399-9314
Mailing address
1588 MATLOCK DR, FLORISSANT, MO 63031-1512
(314) 399-9314
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2012037172
MO
Other
Enumeration date
03/19/2015
Last updated
03/19/2015
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