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Individual

DEENA S COUSINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
2645 W CLAY ST, SAINT CHARLES, MO 63301-2525
(314) 323-7788
Mailing address
36 CRABAPPLE CT, OLIVETTE, MO 63132-3416
(314) 323-7788

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2013006131
MO

Other

Enumeration date
01/27/2015
Last updated
01/27/2015
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