Jonathan Dale Rosenboom PSY.D.

NPI 1679716864 - Psychologist - 103TC0700X

NPI Details
NPI 1679716864
Gender Male
Enumeration Date 04/17/2009
Last Updated 04/17/2009
Entity Type Individual
Active Over 8 years ago
Practice Location
1901 N WESTWOOD BLVD
SUITE 5
POPLAR BLUFF MO, 63901-2800, US
Phone (573) 680-6509
Fax (573) 760-0201
Business Location
1901 N WESTWOOD BLVD
SUITE 5
POPLAR BLUFF MO, 63901-2800, US
Phone (573) 680-6509
Fax (573) 760-0201
Toxanomy
Taxonomy Code 103TC0700X
License State Missouri
License Number PY01221
Remove 1679716864 NPI Number
 

According to our database, Dr. Jonathan Dale Rosenboom PSY.D. NPI is 1679716864, taxonomy code is 103TC0700X and license number is PY01221, license state is located at Missouri. Jonathan Dale Rosenboom PSY.D. physically located at 1901 N Westwood Blvd, Poplar Bluff MO, 63901-2800. NPI Number Jonathan Dale Rosenboom PSY.D. has the Individual type.

Sponsored links

1679716864 NPI number is provided on an as is basis without warranty of any kind. 1679716864 is maintained by the National Plan & Provider Enumeration System. The contents of Jonathan Dale Rosenboom PSY.D. are for informational purposes only.