Organization
MAGNOLIA COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID WELLS (OFFICE MANAGER)
(630) 235-3423
Entity
Organization
Contact information
Practice address
3817 RAYMOND AVE, BRIDGETON, MO 63044-2932
(314) 623-4272
Mailing address
3817 RAYMOND AVE, BRIDGETON, MO 63044-2932
(314) 623-4272
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/01/2021
Last updated
11/01/2021
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