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Individual

MRS. BERNICE JEAN THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW,LCSW

Contact information

Practice address
9378 OLIVE BLVD, SUITE 317, SAINT LOUIS, MO 63132-3215
(314) 994-9344
Mailing address
9378 OLIVE BLVD, SUITE 317, SAINT LOUIS, MO 63132-3215
(314) 994-9344

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
104100000X
MO
251V00000X
Voluntary or Charitable Agency
251V00000X

Other

Enumeration date
12/10/2012
Last updated
12/10/2012
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