Individual
MR. DONNELL MOORE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4452 RUSSELL BLVD, SAINT LOUIS, MO 63110-3210
(314) 503-5337
Mailing address
4452 RUSSELL BLVD, SAINT LOUIS, MO 63110-3210
(314) 503-5337
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2010041604
MO
Other
Enumeration date
04/26/2022
Last updated
04/26/2022
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