Doctor Name: | MICHELE MEARS |
NPI Number: | 1043384837 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PLPC |
License Number: | 2006008227 |
Business Practice Address: | 1406 S 17th Ave Ozark, MO - 657218435 |
Business Phone Number: | 4175814849 |
Business Fax Number: | |
Mailing Address: | 576 E Libby Dr, SPRINGFIELD |
State: | MO |
Postal Code: | 658034554 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2006008227 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |