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Individual

MS. JULIE MICHELLE WIECHENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.W., L.C.S.W

Contact information

Practice address
2440 EXECUTIVE DR, SUITE 210, SAINT CHARLES, MO 63303-5607
(636) 447-1902
(636) 447-1902
Mailing address
2440 EXECUTIVE DR, SUITE 210, SAINT CHARLES, MO 63303-5607
(636) 447-1902
(636) 447-1902

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2001022988
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
194696
PROVIDER IDENTIFICATION
MO
01
300138569
PROVIDER IDENTIFICATION
MO
05
494785314
MO
01
539410
PROVIDER IDENTIFICATION
MO
Enumeration date
10/17/2006
Last updated
01/16/2013
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