Individual
GRACE JORGENSEN COPELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-MHSP
Contact information
Practice address
625 MERAMEC STATION RD, MANCHESTER, MO 63021-5550
(314) 626-4110
Mailing address
9210 EWERS DR, SAINT LOUIS, MO 63126-2521
(901) 604-2451
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2024003577
MO
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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