Doctor Name: | MR. RICHARD LEE WELLS |
NPI Number: | 1841493434 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 120 Brooks St Apt 17 Licking, MO - 655428031 |
Business Phone Number: | 5738899534 |
Business Fax Number: | |
Mailing Address: | Po Box 4449, WAYNESVILLE |
State: | MO |
Postal Code: | 655834449 |
Phone Number: | 5738899534 |
Fax Number: | |
NPI Enumeration Date: | 06/09/2007 |
NPI Last Update Date: | 01/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP1600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Pastoral |
Taxonomy Definition: |