Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 004908 | MO |
NPI | 1003261546 |
---|---|
Provider Name | Lorna L Wurm |
First Address | St.louis, MO 63141 |
Second Address | St.louis, MO 63141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2016 |
Last Update Date | 03/05/2016 |