Individual
MRS. TERA FELDT GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
VIA GIORGIO CORBETTA, 17, VICENZA, VI 36100
(314) 636-9000
Mailing address
UNIT 31403 BOX 13, APO, AE 09630-1403
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C4116
MS
Other
Enumeration date
02/29/2020
Last updated
02/29/2020
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