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Individual

ASHLEY R. WISDOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
851 E 5TH ST STE 308, WASHINGTON, MO 63090-3130
(636) 432-5500
Mailing address
851 E 5TH ST STE 308, WASHINGTON, MO 63090-3130
(636) 432-5500

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
2023041088
MO
101YP2500X
Professional Counselor
Primary
2023041088
MO

Other

Enumeration date
10/11/2023
Last updated
12/17/2024
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