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General NPI Number Information
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NPI Number | 1588349120
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Entity Type | Organization
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Legal Business Name | CARISSA RUPP COUNSELING, INC
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 332A JUNGERMANN RD
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City | SAINT PETERS
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State | MO
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Zip | 63376-5303
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Country | US
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Telephone | 314-744-9253
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Fax |
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Provider Business Mailing Address
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Address Line | 203 CHARGING BEAR DR
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City | WENTZVILLE
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State | MO
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Zip | 63385-3539
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARISSA RUPP
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Credential | MA
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Telephone | 636-293-2471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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