Individual
ANN MARIE WIESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11222 TESSON FERRY RD, SUITE 200, SAINT LOUIS, MO 63123-6963
(314) 780-0817
Mailing address
3020 WOODBRIDGE CREEK DR, SAINT LOUIS, MO 63129-6413
(314) 846-4343
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW003019
MO
Other
Enumeration date
11/19/2008
Last updated
11/19/2008
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