Individual
MARY BRIDGET HENNICKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
7200 MANCHESTER RD, SAINT LOUIS, MO 63143-2403
(314) 375-6282
Mailing address
7200 MANCHESTER RD, SAINT LOUIS, MO 63143-2403
(314) 375-6282
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2018018557
MO
Other
Enumeration date
10/22/2024
Last updated
10/22/2024
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