Individual
LAUREL LYNNE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, LPC
Contact information
Practice address
758 CHAMBERLAIN PL STE 100, WEBSTER GROVES, MO 63119-2782
(314) 834-0655
Mailing address
739 CLARK AVE, WEBSTER GROVES, MO 63119-1912
(314) 606-7552
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2016035429
MO
101YP2500X
Professional Counselor
Primary
2016035429
MO
Other
Enumeration date
02/19/2020
Last updated
04/12/2022
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