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Individual

MARLENA FAYE WISNASKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15455 CONWAY RD STE 117, CHESTERFIELD, MO 63017-2022
(636) 675-7566
Mailing address
4243 S PERADOTTI RD, EDWARDSVILLE, IL 62025-4543
(618) 670-6067

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
06/07/2023
Last updated
06/07/2023
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