| Core14 Llc | |
|
2700 N Range Line Rd Suite 101 Joplin MO 64801-9100 | |
| (417) 627-9601 | |
| (417) 627-9032 |
| Full Name | Core14 Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2700 N Range Line Rd, Joplin, Missouri |
| Authorized Official Name and Position | Jennifer Alberty (PSYCHOLOGIST) |
| Authorized Official Contact | 4176279601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Core14 Llc 2700 N Range Line Rd Suite 101 Joplin MO 64801-9100 Ph: (417) 627-9601 | Core14 Llc 2700 N Range Line Rd Suite 101 Joplin MO 64801-9100 Ph: (417) 627-9601 |
| NPI Number | 1982955191 |
|---|---|
| Provider Enumeration Date | 09/27/2012 |
| Last Update Date | 10/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982955191 | NPI | - | NPPES |
| 1881783066 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2003019242 (Missouri) | Primary |
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