Individual
KATHY B ENTRUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
12015 MANCHESTER RD, SU 190, SAINT LOUIS, MO 63131-4423
(217) 222-8977
(217) 222-8977
Mailing address
12015 MANCHESTER RD, SU 190, SAINT LOUIS, MO 63131-4423
(217) 222-8977
(217) 222-8977
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.004734
IL
101YP2500X
Professional Counselor
2000168606
MO
Other
Enumeration date
04/14/2009
Last updated
04/14/2009
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