Individual
MICA DEANN SUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSM
Contact information
Practice address
10640 BUSINESS 21, HILLSBORO, MO 63050-5039
(618) 877-4420
Mailing address
448 WYLIE DR, NORMAL, IL 61761-5405
(888) 924-3786
(309) 451-7763
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
5137-M
AR
1041C0700X
Clinical Social Worker
Primary
2020017507
MO
Other
Enumeration date
06/17/2008
Last updated
06/25/2020
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