Doctor Name: | MRS. BETH E CANTRELL |
NPI Number: | 1144355371 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2006030818 |
Business Practice Address: | 6007 N 21st St Ozark, MO - 657217634 |
Business Phone Number: | 4175816911 |
Business Fax Number: | |
Mailing Address: | 3778 N Delaware Ave, SPRINGFIELD |
State: | MO |
Postal Code: | 658033788 |
Phone Number: | 4178330468 |
Fax Number: | |
NPI Enumeration Date: | 02/21/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2006030818 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |