| Doctor Name: | JILL B. WADE |
| NPI Number: | 1700022209 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PLPC |
| License Number: | 2008006368 |
| Business Practice Address: | 741 N. State Hwy 5 Camdenton, MO - 65020 |
| Business Phone Number: | 5733179100 |
| Business Fax Number: | 5733179104 |
| Mailing Address: | 1800 Community, CLINTON |
| State: | MO |
| Postal Code: | 647358804 |
| Phone Number: | 6608908186 |
| Fax Number: | 8163183109 |
| NPI Enumeration Date: | 01/05/2009 |
| NPI Last Update Date: | 01/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2008006368 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |