Individual
MARY WALLACE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDS, MED, BSED
Contact information
Practice address
8857 NEW SAPPINGTON RD, SAINT LOUIS, MO 63126-1946
(314) 330-1848
Mailing address
8857 NEW SAPPINGTON RD, SAINT LOUIS, MO 63126-1946
(314) 330-1848
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
MO
Other
Enumeration date
09/30/2025
Last updated
09/30/2025
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