Provider Information for 1982740452
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Dr. BRENDA SUE MELTON LPC
Other Names:Former Name:Dr. BRENDA SUE POTZ KIEFFER LPCSex: Female
NPI: 1982740452
Last Updated: 2024-01-31
Certification Date: 2024-01-31
Certification Date: 2024-01-31
Details
Name | Value | ||||||||
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NPI | 1982740452 | ||||||||
Enumeration Date | 2007-01-30 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 7711 KENRIDGE LN SAINT LOUIS, MO 63119-4307 United States Phone: 314-808-2382 | Fax:314-395-8433 | ||||||||
Primary Practice Address | 7711 KENRIDGE LN SAINT LOUIS, MO 63119-4307 United States Phone: 314-808-2382 | Fax:341-395-8433 | ||||||||
Secondary Practice Address(es) | 2510 S BRENTWOOD BLVD STE 207 | ||||||||
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