Individual
BRIAN GROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2599
(314) 712-5157
Mailing address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2516
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
627463
MO
103TS0200X
School Psychologist
—
—
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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