Individual
MRS. TIFFANY NICOLE WYMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA.,PLPC
Contact information
Practice address
9666 OLIVE BLVD STE 370, SAINT LOUIS, MO 63132-3025
(573) 701-2872
Mailing address
623 N CHARLES ST, BELLEVILLE, IL 62220-4021
(573) 701-2872
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2016034260
MO
Other
Enumeration date
10/14/2016
Last updated
02/10/2025
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