Individual
MR. JERRY W. KIESLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
19501 N ROUTE V, STURGEON, MO 65284
(573) 819-5065
Mailing address
19501 N ROUTE V, STURGEON, MO 65284
(573) 819-5065
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2011001843
MO
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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