Susan Mary Self-Portwine, LCSW
NPI #1407195753 in House Springs, Missouri
Provider Information
- NPI Number
- 1407195753
- Entity Type
- Individual
- Name
- Susan Mary Self-Portwine, LCSW
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Social Worker - Clinical
- Credential
- LCSW
- Enumeration Date
- Feb 6, 2013
- Last Updated
- Apr 5, 2024
Practice Location
- Address
- 7080 RIVERMONT TRL
- City
- House Springs
- State
- Missouri
- ZIP Code
- 63051-2081
- Phone
- (314) 643-6990
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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