Mary Ellen Theodore LPC

NPI 1699933630 - Counselor - 101YP2500X

NPI Details
NPI 1699933630
Gender Female
Enumeration Date 05/27/2008
Last Updated 05/27/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
321 N MUNN AVE
MARYVILLE MO, 64468-2146, US
Phone (660) 582-3086
Fax (660) 582-3086
Business Location
321 N MUNN AVE
MARYVILLE MO, 64468-2146, US
Phone (660) 582-3086
Fax (660) 582-3086
Toxanomy
Taxonomy Code 101YP2500X
License State Missouri
License Number 002394
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According to our database, Mrs. Mary Ellen Theodore LPC NPI is 1699933630, taxonomy code is 101YP2500X and license number is 002394, license state is located at Missouri. Mary Ellen Theodore LPC physically located at 321 N Munn Ave, Maryville MO, 64468-2146. NPI Number Mary Ellen Theodore LPC has the Individual type.

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1699933630 NPI number is provided on an as is basis without warranty of any kind. 1699933630 is maintained by the National Plan & Provider Enumeration System. The contents of Mary Ellen Theodore LPC are for informational purposes only.