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Individual

MRS. LATISHA JO RICHESON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
1926 OAK ST, UNIONVILLE, MO 63565-1180
(660) 947-3673
Mailing address
213 MARKHAM CT, BROOKFIELD, MO 64628-1953
(816) 304-6183

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2013017695
MO

Other

Enumeration date
04/06/2020
Last updated
04/06/2020
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