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General NPI Number Information
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NPI Number | 1376648253
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Entity Type | Organization
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Legal Business Name | S.T.R.I.VE., LLC.
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11005 ACTON DR
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City | SAINT LOUIS
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State | MO
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Zip | 63123-7003
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Country | US
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Telephone | 314-540-0545
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Fax | 314-892-8765
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Provider Business Mailing Address
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Address Line | PO BOX 270005
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City | SAINT LOUIS
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State | MO
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Zip | 63127-0005
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Country | US
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Telephone | 314-540-0545
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Fax | 314-540-0545
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | SONJA WILLIAMS
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Credential | L.P.C.
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Telephone | 314-540-0545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2003032184
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License Number State | MO
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