Individual
MRS. JESSICA A ROESELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4326 LINDELL BLVD, SAINT LOUIS, MO 63108-2702
(314) 533-2229
(314) 533-0647
Mailing address
4326 LINDELL BLVD, SAINT LOUIS, MO 63108-2702
(314) 533-2229
(314) 533-0647
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2011016671
MO
1041C0700X
Clinical Social Worker
Primary
2011016671
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011016671
LICENSE NUMBER
MO
Enumeration date
07/18/2011
Last updated
06/20/2016
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