| Forest Institute Clinic | |
|
1322 S Campbell Ave Springfield MO 65807-1445 | |
| (417) 893-7990 | |
| (417) 831-6839 |
| Full Name | Forest Institute Clinic |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1322 S Campbell Ave, Springfield, Missouri |
| Authorized Official Name and Position | Jennifer Baker (CLINIC DIRECTOR) |
| Authorized Official Contact | 4178937994 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forest Institute Clinic 1322 S Campbell Ave Springfield MO 65807-1445 Ph: (417) 893-7990 | Forest Institute Clinic 1322 S Campbell Ave Springfield MO 65807-1445 Ph: (417) 893-7990 |
| NPI Number | 1235184243 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 09/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235184243 | NPI | - | NPPES |
| 507536803 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2004033841 (Missouri) | Primary |
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