Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | MO000467 | MO |
NPI | 1003009333 |
---|---|
Provider Name | Deborah Molly Levin |
First Address | Saint Louis, MO 63131-2913 |
Second Address | Saint Louis, MO 63131-2913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2007 |
Last Update Date | 05/12/2017 |