Individual provider · Type 1 NPI

Loren Gaillardetz

Mental Health Counselor · Maplewood, MO

NPI number 1164039103 Active

Practice location

3008 Sutton Blvd Ste 200
Maplewood, MO 63143-3064

Call (314) 328-4402 Map

Mailing address

6365 Clayton Rd
Clayton, MO 63117-1808

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X2019009357 (MO)

Mental Health Counselor: Definition to come...

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About NPI 1164039103

Loren Gaillardetz's National Provider Identifier is 1164039103, issued on Sep 24, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Maplewood, MO. The record was last updated on Aug 6, 2021.