Individual
JOHN W KISTHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1126 E HIGHWAY WW, MARSHALL, MO 65340-4641
(660) 886-2253
(660) 886-6601
Mailing address
1126 E HIGHWAY WW, MARSHALL, MO 65340-4641
(660) 886-2253
(660) 886-6601
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2017038784
MO
Other
Enumeration date
11/01/2017
Last updated
11/01/2017
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