Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor |
NPI | 1003491937 |
---|---|
Provider Name | Scott Steven Heuer |
First Address | Saint Louis, MO 63104-2508 |
Second Address | Saint Louis, MO 63104-2508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2021 |
Last Update Date | 11/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2019019350 | LICENSED PROFESSIONAL COUNSELOR (01) | MO |