Individual
DEANNA JOYCE ELIZABETH SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1000 LAKE SAINT LOUIS BLVD, SUITE NUMBER 250, LAKE SAINT LOUIS, MO 63367-1340
(314) 570-5960
Mailing address
1000 LAKE SAINT LOUIS BLVD, SUITE NUMBER 250, LAKE SAINT LOUIS, MO 63367-1340
(314) 570-5960
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2008002253
MO
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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