MEDICARE: MRS. DONDRA MARIE AGOVINO MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2014000730	MO

General Provider Information

NPI Number	:	1538709787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONDRA MARIE AGOVINO MA

Provider Business Mailing Address
First Line	:	3832 UTAH PL
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63116-4833
Country	:	US
Telephone Number	:	636-578-4781
Fax Number	:

Provider Business Practice Location Address
First Line	:	3892 WYOMING ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63116-4841
Country	:	US
Telephone Number	:	636-578-4781
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2020
Last Update Date	:	12/01/2025

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