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Individual

DR. URSULA WIESE MARSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
219 CREEKSIDE OFFICE DRIVE, WENTZVILLE, MO 63385-3290
(636) 357-0136
(636) 639-1004
Mailing address
7 COUNTRY RD, P.O. BOX 186, FORISTELL, MO 63348-1722
(636) 332-6906
(636) 639-1004

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2007036957
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1114164977
NPI (1)
01
1649503772
NPI (2)
Enumeration date
01/15/2009
Last updated
11/17/2010
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