Individual provider · Type 1 NPI

Darrell Provinse, L.P.C.

Professional Counselor · St. Louis, MO

NPI number 1245380641 Active

Practice location

9378 Olive Blvd, Ste. 317
St. Louis, MO 63132-3215

Call (314) 994-9344 Map

Fax (314) 994-3007

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X2004003789 (MO)

Professional Counselor: Definition to come...

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About NPI 1245380641

Darrell Provinse, L.P.C.'s National Provider Identifier is 1245380641, issued on Jan 10, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in St. Louis, MO. The record was last updated on Jul 8, 2007.