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Individual

MRS. JENNIFER MARIE WICKERSHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.P.C.

Contact information

Practice address
69 TURF CT, WEBSTER GROVES, MO 63119-4619
(314) 651-2179
Mailing address
69 TURF CT, WEBSTER GROVES, MO 63119-4619
(314) 651-2179

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002754
MO

Other

Enumeration date
02/08/2011
Last updated
05/31/2024
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