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Individual

DIANA GREGORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
3751 PENNRIDGE DR STE 119, BRIDGETON, MO 63044-1244
(314) 443-7776
(949) 561-4148
Mailing address
1 SHAMBLIN RD, FLORISSANT, MO 63034-1354
(314) 691-6085

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
11/11/2020
Last updated
11/11/2020
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