Individual
MARY E WENOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1272 JUNGERMANN RD STE C, SAINT PETERS, MO 63376-6968
(636) 928-5800
Mailing address
13029 TWIN MEADOWS CT, SAINT LOUIS, MO 63146-1804
(314) 434-5658
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW005179
MO
Other
Enumeration date
08/03/2006
Last updated
02/13/2009
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