Center For Creative Change
Counselor, Mental Health in Farmington, MO. Organization (NPI-2).
NPI number1619201746
StatusActive
Last updated in NPPESSep 22, 2009
Details
- NPI
- 1619201746
- Entity type
- Organization (NPI-2)
- Legal business name
- Center For Creative Change
- Organization subpart
- No
- Enumeration date
- Sep 22, 2009
- Last updated
- Sep 22, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 001502 | MO | Yes |
Practice location
506 North StFarmington, MO 63640-3213
Phone 573-756-3330 · Fax 573-747-3023
Mailing address
Po Box 506Farmington, MO 63640-0506
Phone 573-756-3330 · Fax 573-747-3023
Authorized official
Lynn S James
Counselor/Owner
5737563330
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