| Doctor Name: | MS. THERESA ANGELA PALMER |
| NPI Number: | 1770649451 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.P.C. |
| License Number: | CS000583 |
| Business Practice Address: | 605 S 2nd St De Soto, MO - 630202010 |
| Business Phone Number: | 6365864655 |
| Business Fax Number: | 6362430782 |
| Mailing Address: | Po Box 104, FESTUS |
| State: | MO |
| Postal Code: | 630280104 |
| Phone Number: | 6365864655 |
| Fax Number: | 6362430782 |
| NPI Enumeration Date: | 12/28/2006 |
| NPI Last Update Date: | 01/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | CS000583 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |