Individual
KRISTEN WATERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2104 COLLIER CORPORATE PKWY, SAINT CHARLES, MO 63303-6708
(636) 422-0303
Mailing address
107 IRON GATE CT, SAINT CHARLES, MO 63304-7278
(636) 699-5545
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC2013002022
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490002701
—
MO
Enumeration date
01/30/2013
Last updated
01/02/2024
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