Mary Lou Bourque, LPC
NPI #1750380515 in Saint Louis, Missouri
Provider Information
- NPI Number
- 1750380515
- Entity Type
- Individual
- Name
- Mary Lou Bourque, LPC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Mental Health
- Credential
- LPC
- Enumeration Date
- Jul 14, 2005
- Last Updated
- Jul 12, 2007
Practice Location
- Address
- 763 S NEW BALLAS RD
- Address 2
- SUITE 110
- City
- Saint Louis
- State
- Missouri
- ZIP Code
- 63141-8704
- Phone
- (314) 569-1717
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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