| Encore Pediatrics Of Missouri, Llc | |
|
221 Bolivar St Jefferson City MO 65101-1572 | |
| (866) 925-8505 | |
| Not Available |
| Full Name | Encore Pediatrics Of Missouri, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 221 Bolivar St, Jefferson City, Missouri |
| Authorized Official Name and Position | John Cotcher (EVP OF PEDIATRICS) |
| Authorized Official Contact | 2486722593 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Encore Pediatrics Of Missouri, Llc 33533 W 12 Mile Rd Ste 290 Farmington Hills MI 48331-5635 Ph: (216) 202-8260 | Encore Pediatrics Of Missouri, Llc 221 Bolivar St Jefferson City MO 65101-1572 Ph: (866) 925-8505 |
| NPI Number | 1255048062 |
|---|---|
| Provider Enumeration Date | 11/01/2022 |
| Last Update Date | 08/21/2024 |
| Certification Date | 08/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255048062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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