Individual
MS. KELLY M HEIRONIMUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
760 PLANTATION BLVD, SIKESTON, MO 63801-5736
(573) 471-0800
(573) 471-0810
Mailing address
760 PLANTATION BLVD, PO BOX 1043, SIKESTON, MO 63801-5736
(573) 471-0800
(573) 471-0810
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2012035820
MO
Other
Enumeration date
02/07/2013
Last updated
02/07/2013
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