Trista E Fongemie, MS, PLPC
Counselor, Professional in Springfield, MO. Individual provider (NPI-1).
NPI number1962067975
StatusActive
Last updated in NPPESOct 6, 2020
Details
- NPI
- 1962067975
- Entity type
- Individual (NPI-1)
- Name
- Trista E Fongemie
- Credential
- MS, PLPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 6, 2019
- Certification date
- Oct 6, 2020
- Last updated
- Oct 6, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 2019037082 | MO | Yes |
Other names
- Trista E Ames (Former Name)
Practice location
1300 E Bradford PkwySpringfield, MO 65804-4264
Phone 417-761-5000 · Fax 417-761-5011
Mailing address
1300 E Bradford PkwySpringfield, MO 65804-4264
Phone 417-761-5000 · Fax 417-761-5011
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