Individual provider · Type 1 NPI
Evelyn Aviva Witten
Professional Counselor · St. Louis, MO
NPI number
1508486333
Active
Practice location
130 S Bemiston Ave Ste 604
St. Louis, MO 63105-1913
Mailing address
18 Dunleith Dr
St. Louis, MO 63124-1895
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 2000143572 (MO) |
Professional Counselor: Definition to come...
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About NPI 1508486333
Evelyn Aviva Witten's National Provider Identifier is 1508486333, issued on Apr 22, 2020. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in St. Louis, MO. The record was last updated on Apr 22, 2020.