Individual
MS. SUSAN IGNAZITO-WILHELM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAC, LPC
Contact information
Practice address
3134 SUTTON BLVD, MAPLEWOOD, MO 63143-3910
(314) 375-6475
Mailing address
7218 TALL OAK CT, SAINT LOUIS, MO 63129-5650
(314) 375-6475
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2011039644
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
499508802
—
MO
Enumeration date
05/04/2012
Last updated
05/15/2019
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