Individual
MR. MICHAEL JEROME WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
9155 HEMIS FAIR DR, SAINT LOUIS, MO 63136-4006
(314) 898-5218
Mailing address
9155 HEMIS FAIR DR, SAINT LOUIS, MO 63136-4006
(314) 898-5218
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000331
MO
225700000X
Massage Therapist
2004003080
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
493267322
—
MO
Enumeration date
01/18/2007
Last updated
09/09/2009
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