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Organization

CHANGE AND DEVELOPMENT INSTITUTE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES CARROLL LPC (PRESIDENT)
(314) 680-8179
Entity
Organization

Contact information

Practice address
8123 JANUARY AVE, SAINT LOUIS, MO 63134-1513
(314) 680-8179
Mailing address
8123 JANUARY AVE, SAINT LOUIS, MO 63134-1513
(314) 680-8179

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2007036005
MO

Other

Enumeration date
12/09/2009
Last updated
12/09/2009
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