Individual
MR. MOYENDA ANWISYE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1422 GRANVILLE PL, SAINT LOUIS, MO 63112-4202
(314) 749-5954
Mailing address
PO BOX 29033, SAINT LOUIS, MO 63112-0733
(314) 749-5954
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2011040308
MO
Other
Enumeration date
12/23/2013
Last updated
12/23/2013
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