Doctor Name: | MS. JANETTE BIZZELL |
NPI Number: | 1033108758 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA LPC NCC |
License Number: | 001631 |
Business Practice Address: | 4 Fairways Cir Unit C Saint Charles, MO - 633033347 |
Business Phone Number: | 6369462688 |
Business Fax Number: | 6369462688 |
Mailing Address: | 4 Fairways Cir, Unit C SAINT CHARLES |
State: | MO |
Postal Code: | 633033347 |
Phone Number: | 6369462688 |
Fax Number: | 6369462688 |
NPI Enumeration Date: | 10/14/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 001631 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |