Individual
MOLLY WICKENHAUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 289-7671
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071011123
IL
Other
Enumeration date
07/14/2019
Last updated
04/11/2024
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