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Individual

CAROL RUTH CHILDERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.W., L.C.S.W.

Contact information

Practice address
252 JUPITER RD, CAMDENTON, MO 65020-4442
(909) 224-2069
Mailing address
PO BOX 1262, SUNRISE BEACH, MO 65079-1262
(909) 224-2069

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2004029296
MO
1041C0700X
Clinical Social Worker
LCS13133
CA

Other

Enumeration date
09/03/2008
Last updated
06/21/2013
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