| Doctor Name: | MS. JERILIE DEGUIRE |
| NPI Number: | 1013289198 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PLPC |
| License Number: | 2011004232 |
| Business Practice Address: | 89 Mccrory Drive Camdenton, MO - 65020 |
| Business Phone Number: | 5732167247 |
| Business Fax Number: | |
| Mailing Address: | Po Box 3214, CAMDENTON |
| State: | MO |
| Postal Code: | 650203214 |
| Phone Number: | 5732167247 |
| Fax Number: | |
| NPI Enumeration Date: | 02/03/2012 |
| NPI Last Update Date: | 02/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2011004232 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |