Individual
MS. MARY KATHERINE WILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
7750 CLAYTON RD STE 310, SAINT LOUIS, MO 63117-1341
(314) 858-6884
Mailing address
10 LAKE FOREST DR, SAINT LOUIS, MO 63117-1304
(978) 257-0184
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2019007551
MO
Other
Enumeration date
05/22/2019
Last updated
05/22/2019
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