Loren Gaillardetz
Counselor, Mental Health in Maplewood, MO. Individual provider (NPI-1).
NPI number1164039103
StatusActive
Last updated in NPPESAug 6, 2021
Details
- NPI
- 1164039103
- Entity type
- Individual (NPI-1)
- Name
- Loren Gaillardetz
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 24, 2020
- Certification date
- Aug 5, 2021
- Last updated
- Aug 6, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 2019009357 | MO | Yes |
Practice location
3008 Sutton Blvd Ste 200Maplewood, MO 63143-3064
Phone 314-328-4402
Mailing address
6365 Clayton RdClayton, MO 63117-1808
Phone 314-328-4402
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