Individual
MARISA RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
601 MEADOWBROOK CT, DESLOGE, MO 63601-3000
(573) 747-9789
Mailing address
601 MEADOWBROOK CT, DESLOGE, MO 63601-3000
(573) 747-9789
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005719
MO
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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