Individual
MS. KIM LESLEY FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, MTS
Contact information
Practice address
377 CHAPEL RIDGE DR, APT C, HAZELWOOD, MO 63042-2671
(314) 570-4065
Mailing address
1323 SULLIVAN AVE, APT C, SAINT LOUIS, MO 63107-3919
(314) 503-1746
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004287
MO
Other
Enumeration date
06/26/2008
Last updated
06/01/2016
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