Individual
STEPHANIE GILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2200 BROWN RD, SAINT LOUIS, MO 63114-5512
(314) 666-4191
Mailing address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2599
(314) 666-4191
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/11/2018
Last updated
10/11/2018
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