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ISAAC DONNELL HUDDLESTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
392 CHEZ PAREE DR, HAZELWOOD, MO 63042-3539
(314) 833-7080
Mailing address
392 CHEZ PAREE DR, HAZELWOOD, MO 63042-3539
(314) 833-7080

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2008004281
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
494055700
MO
Enumeration date
03/09/2008
Last updated
09/23/2021
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