Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | 3755 | IL |
N | 101YP1600X | Pastoral Counselor | 3755 | MO |
Y | 101YP2500X | Professional Counselor | IL |
NPI | 1073706248 |
---|---|
Provider Name | Dr. Brian Glen Storey |
First Address | Saint Louis, MO 63131-4730 |
Second Address | Glen Carbon, IL 62034-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2007 |
Last Update Date | 21/08/2007 |