Individual
MARY NYE ST.CLAIR
Active
Individual
MARY NYE ST.CLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, ATR-BC, CGP
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW00003838
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209651
ANTHEM BCBS
MO
05
—
490614104
—
MO
Enumeration date
04/10/2006
Last updated
02/27/2009
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