Organization
JUMP START COUNSELING
Active
Organization
JUMP START COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLA BROEKER M.A. LPC (OWNER)
(636) 357-1996
Entity
Organization
Contact information
Practice address
1351 PRAIRIE RD, HAWK POINT, MO 63349-2062
(636) 357-1996
Mailing address
1351 PRAIRIE RD, HAWK POINT, MO 63349-2062
(636) 357-1996
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2002010834
MO
101YM0800X
Mental Health Counselor
2002010834
MO
101YP2500X
Professional Counselor
Primary
2002010834
MO
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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