Individual
CLARICE WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 JEFFERSON BARRACKS DR, JB-PRIMARY CARE 11F2/JB, SAINT LOUIS, MO 63125-4181
(314) 652-4100
Mailing address
117 FOREST PKWY, APT. D, VALLEY PARK, MO 63088-1057
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2438
KS
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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