Individual
NANCY L WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
316 S 2ND ST, SUITE A, SAINT CHARLES, MO 63301-3402
(636) 949-6605
(636) 949-6607
Mailing address
PO BOX 69, SAINT CHARLES, MO 63302-0069
(636) 949-6605
(636) 949-6607
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005343
MO
Other
Enumeration date
02/13/2007
Last updated
03/12/2013
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