Individual
MISS KELLY ANN MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAC
Contact information
Practice address
9378 OLIVE BLVD, STE. 317, SAINT LOUIS, MO 63132-3215
(314) 994-9344
Mailing address
9378 OLIVE BLVD, STE. 317, SAINT LOUIS, MO 63132-3215
(314) 994-9344
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/05/2009
Last updated
10/05/2009
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