Individual
QIYUN GAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1034 S BRENTWOOD BLVD STE 555, RICHMOND HEIGHTS, MO 63117-1265
(314) 596-2448
Mailing address
1507 WILD BERRY CT, BALLWIN, MO 63021-7776
(812) 345-8634
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2015040582
MO
1041C0700X
Clinical Social Worker
Primary
2018030143
MO
Other
Enumeration date
05/05/2017
Last updated
04/04/2026
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