Individual
STEPHANIE LAURETTE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3608 HEREFORD ST, SAINT LOUIS, MO 63109-1771
(314) 243-0815
Mailing address
3608 HEREFORD ST, SAINT LOUIS, MO 63109-1771
(314) 243-0815
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
Primary
13402
MO
Other
Enumeration date
08/20/2019
Last updated
02/19/2021
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