person
Mr. Mark Ernest Wardlow JR., MA,LPC,CCDP-D
Professional Counselor in Farmington, Missouri
NPI 1942544630

Mark Ernest Wardlow JR. is a Professional Counselor based in Farmington, MO and is specialized in Professional. Mark Ernest Wardlow JR. practices in Farmington, MO and has the professional credentials of MA,LPC,CCDP-D. The NPI Number for Mark Ernest Wardlow JR. is 1942544630 and holds a License No. 5866 (Missouri).

The current practice location address for Mark Ernest Wardlow JR. is 1528 Highway H, Farmington, MO and can be reached out via phone at 573-915-4123.

Location: 1528 Highway H, Farmington, MO, 63640-7042
person
Provider Profile Details
NPI Number
1942544630
Provider Name
Mark Ernest Wardlow JR.
Credential
MA,LPC,CCDP-D
Provider Entity Type
Individual
Gender
Male
Address
1528 Highway H, Farmington, MO, 63640-7042
Phone Number
573-915-4123
Fax Number
Provider Enumeration Date
11/19/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1528 Highway H
City
State
Zip
63640-7042
Phone Number
573-915-4123
Fax Number
person
Provider Business Mailing Address Details
Address
1528 Highway H
City
State
Zip
63640-7042
Phone Number
573-915-4123
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
2016014454 (Missouri)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
5866 (Missouri)
Definition
Definition to come...
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