Individual
MS. KELLY LEIGH STICKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, MSW, LMSW
Contact information
Practice address
1438 S GRAND BLVD, SAINT LOUIS, MO 63104-1027
(314) 977-4885
Mailing address
6289 MARMADUKE AVE, SAINT LOUIS, MO 63139-2613
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2016042867
MO
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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