Individual
MRS. GLENDA MARIE MARESCHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
500 MEDICAL DR, WENTZVILLE, MO 63385-3421
(636) 688-9907
Mailing address
500 MEDICAL DR, WENTZVILLE, MO 63385-3421
(636) 688-9907
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2011027864
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431343281
—
MO
Enumeration date
01/22/2019
Last updated
01/22/2019
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