| Innovation Avenue Consulting Llc | |
|
606 Davidson Ct Saint Peters MO 63376-2472 | |
| (314) 246-9249 | |
| Not Available |
| Full Name | Innovation Avenue Consulting Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 606 Davidson Ct, Saint Peters, Missouri |
| Authorized Official Name and Position | Kenyota Maria Dokes (LEAD COUNSELOR) |
| Authorized Official Contact | 3145029682 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovation Avenue Consulting Llc Po Box 1721 Saint Peters MO 63376-0050 Ph: () - | Innovation Avenue Consulting Llc 606 Davidson Ct Saint Peters MO 63376-2472 Ph: (314) 246-9249 |
| NPI Number | 1790103828 |
|---|---|
| Provider Enumeration Date | 04/05/2014 |
| Last Update Date | 04/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790103828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2012005837 (Missouri) | Primary |
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