Individual
MS. MARYANNE MICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
136 HORSESHOE DR, SAINT LOUIS, MO 63122-3714
(314) 800-8747
Mailing address
136 HORSESHOE DR, SAINT LOUIS, MO 63122-3714
(314) 800-8747
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000988
MO
Other
Enumeration date
04/17/2009
Last updated
04/17/2009
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