Organization
DIVERSIFIED HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHA YOST BRADFORD (OWNER)
(314) 698-4266
Entity
Organization
Contact information
Practice address
11042 MANCHESTER RD, KIRKWOOD, MO 63122-1244
(844) 462-3492
(314) 596-4559
Mailing address
11042 MANCHESTER RD, KIRKWOOD, MO 63122-1244
(844) 462-3492
(314) 596-4559
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
01/12/2019
Last updated
01/22/2025
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