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Individual

DR. VIVIAN JUANITA MCCOLLUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D., LPC

Contact information

Practice address
1136 WASHINGTON AVE UNIT 809, SAINT LOUIS, MO 63101-1174
(404) 536-7586
(314) 727-6067
Mailing address
1136 WASHINGTON AVE UNIT 809, SAINT LOUIS, MO 63101-1174
(404) 536-7586
(314) 727-6067

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2015032865
MO
101YP2500X
Professional Counselor
LPC004750
GA

Other

Enumeration date
09/26/2007
Last updated
09/11/2024
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