Individual
PAULA JEAN WISDOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
11667 JINKERSON RD, POTOSI, MO 63664-3012
(573) 436-4809
Mailing address
11667 JINKERSON RD, POTOSI, MO 63664-3012
(573) 436-4809
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003051
MO
Other
Enumeration date
05/01/2007
Last updated
01/05/2011
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