| Doctor Name: | DR. MICHAEL SIMON LONDE |
| NPI Number: | 1033293485 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 437 |
| Business Practice Address: | 712 E 32nd St Ste 1 Joplin, MO - 648043968 |
| Business Phone Number: | 4177812868 |
| Business Fax Number: | 4177811922 |
| Mailing Address: | 712 E 32nd St Ste 1, JOPLIN |
| State: | MO |
| Postal Code: | 648043968 |
| Phone Number: | 4177812868 |
| Fax Number: | 4177811922 |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 437 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |