| Doctor Name: | MR. JONATHAN MICHAEL WELLS |
| NPI Number: | 1255579611 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS, PLPC |
| License Number: | 2009000231 |
| Business Practice Address: | 13160 County Rd 3610 St. James, MO - 65559 |
| Business Phone Number: | 5732653251 |
| Business Fax Number: | 5732658363 |
| Mailing Address: | Po Box 189, SAINT JAMES |
| State: | MO |
| Postal Code: | 655590189 |
| Phone Number: | 5732653251 |
| Fax Number: | 5732658363 |
| NPI Enumeration Date: | 01/23/2009 |
| NPI Last Update Date: | 01/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 2009000231 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |