Individual
RAE WANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 HIGHWAY 9, MORRILTON, AR 72110-9403
(501) 208-5911
(201) 208-5912
Mailing address
118 N 2ND ST STE 200, SAINT CHARLES, MO 63301-2894
(636) 224-1210
(636) 946-0991
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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