Individual
CASEY TYSKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
140 WELDON PKWY, MARYLAND HEIGHTS, MO 63043-3115
(314) 569-2278
Mailing address
3530 YAEGER RD, SAINT LOUIS, MO 63129-2329
(314) 686-2400
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2020009336
MO
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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